Dr.V.Jayapradha BioMedicalElectronics

SRI CHANDRASEKHARENDRA SARASWATHI VISWA MAHAVIDYALAYA
(University established under section 3of UGC Act 1956)

(Accredited with ‘A’ Grade by NAAC)
Enathur, Kanchipuram – 631 561
DEPARTMENT OF ELECTRONICS AND COMMUNICATION ENGINEERING
Course Material
Bio-Medical Electronics
FULL TIME B.E IV YEAR, VIIth SEMESTER
Prepared by:
Dr. V.Jayapradha, Assistant Professor
Sri Chandrasekharendra Saraswathi Viswa Mahavidyalaya
Department of Electronics and Communication Engineering
Syllabus for Full Time BE, Regulations 2018
(Applicable for students admitted from 2018-19 onwards
PEC5 BIO-MEDICAL ELECTRONICS VII SEMESTER
PRE-REQUISTIE:
Basic Knowledge in Electronic Devices and Circuits
OBJECTIVES:
 To learn the electrical and non-electrical physiological measurements
 To understand the function of bio amplifiers.
 To know the configuration of various electrodes
UNIT I BIO POTENTIAL ELECTRODES

Origin of bio potential and its propagation, Electrode-electrolyte interface, electrode–skin interface, half cell
potential, impedance, polarization effects of electrode – non polarisable electrodes. Types of electrodes - surface,
needle and micro electrodes and their equivalent circuits, Recording problems - measurement with two electrodes
UNIT II ELECTRODE CONFIGURATIONS
Bio signals characteristics – frequency and amplitude ranges. ECG – Einthoven’s triangle, standard 12lead system.
EEG – 10-20 electrode system, unipolar, bipolar and average mode, EMG– unipolar and bipolar mode
UNIT III BIO AMPLIFIER
Need for bio-amplifier - single ended bio-amplifier, differential bio-amplifier – right leg driven ECGamplifier. Band
pass filtering, isolation amplifiers – transformer and optical isolation - isolated DC amplifier and AC carrier
amplifier. Chopper amplifier, Power line interference
UNIT IV MEASUREMENT OF NON-ELECTRICAL PARAMETERS
Temperature, respiration rate and pulse rate measurements. Blood Pressure: indirect methods - auscultatory method,
oscillometric method, direct methods: electronic manometer, Pressure amplifiers
- systolic, diastolic, mean detector circuit. Blood flow and cardiac output measurement: Indicator dilution, thermal
dilution and dye dilution method, Electromagnetic and ultrasound blood flow measurement.
UNIT V BIO-CHEMICAL MEASUREMENT
Biochemical sensors - pH, pO2 and pCO2, Ion selective Field effect Transistor (ISFET), immunologically sensitive
FET (IMFET), Blood glucose sensors - Blood gas analyzers, colorimeter, flame photometer, spectrophotometer,
blood cell counter, auto analyzer (simplified schematic description).
OUTCOMES:
At the end of the course, the student should be able to:
 Perform electrical and non-electrical physiological measurements
 Explain the function of bio amplifiers.
TEXT BOOKS:
1. John G. Webster, “Medical Instrumentation Application and Design”, John Wiley and sons, 2004.
2. Khandpur R.S, “Handbook of Biomedical Instrumentation”, Tata McGraw-Hill, 2003.
REFERENCES:
1. Leslie Cromwell, “Biomedical Instrumentation and measurement”, PHI, 2007.
2. Myer Kutz, “Standard Handbook of Biomedical Engineering and Design”, McGrawHill,2003.
Joseph J. Carr & John M. Brown, “Introduction to Biomedical Equipment Technology”, Pearson Education,
2004.
UNIT- I
BIO POTENTIAL ELECTRODES
Origin of bio potential and its propagation, Electrode-electrolyte interface, electrode–skin
interface, half cell potential, impedance, polarization effects of electrode – non polarisable
electrodes. Types of electrodes - surface, needle and micro electrodes and their equivalent
circuits, Recording problems - measurement with two electrodes
DESIGN OF MEDICAL INSTRUMENT

To design any medical instrument, the factors to be considered are
1. Accuracy: ccuracy is the closeness with which an instrument reading approaches the true value
of variable being measured.
2. Frequency Response: It is the response of the instrument for various frequency components
present in a physiological signal.
3. Hysteresis: Hysteresis error occurs due to mechanical friction.
4. Isolation: Electrical isolation is made for electrical safety and to avoid any interference between
different instruments.
5. Linearity: It is defined as the degree to which variations in the output of an instrument follow
input variations
6. Sensitivity: It is the ability of an instrument to detect even a very small change that is taking
place in the input.
7. Signal to Noise (S/N) ratio: It should be high to get reliable information about input.
8. Simplicity: It is an essential one to eliminate the human errors.
9. Stability: It is the ability of the instrument to produce constant output for a given input.
10. Precision: It is the measure of the reproducibility of the measurements.
COMPONENTS OF BIO- MEDICAL INSTRUMENT SYSTEM:
The clinical laboratory instrument is used to investigate the pH value and concentration of various
radicals present in the body fluids and to count blood cells in the blood sample. Each switch
position connects an instrument for measurement, for monitoring, diagnosis, therapy or surgery
with signal processor.
Transducer transforms the physiological signal like temperature, pressure or bio-potential into an
electrical form.
Fig 1.4: Block Diagram of a Generalized Bio-Medical Instrument System

BMT Module -2 BIOELECTRIC SIGNALS AND ELECTRODES
2.1: Sources of Biomedical Signals

Biomedical signals are those signals (phenomenon that conveys information) which are used
primarily for extracting information on a biological system under investigation.
Fig. 1.8 Sources of biomedical signals

The process of extracting information could be as simple as feeling the pulse of a person on
the wrist or as complex as analyzing the structure of internal soft tissues by an ultrasound
scanner. Biomedical signals originate from a variety of sources (Fig. 1.8) such as:
Bioelectric Signals: These are unique to the biomedical systems. They are generated by
nerve cells and muscle cells. Their basic source is the cell membrane potential which under
certain conditions may be excited to generate an action potential. The electric field generated
by the action of many cells constitutes the bio-electric signal. The most common examples of
bioelectric signals are the ECG (electrocardiographic) and EEG (electroencephalographic)
signals.
Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 2

Bioacoustic Signals: The measurement of acoustic signals created by many biomedical

phenomena provides information about the underlying phenomena. The examples of such
signals are: flow of blood in the heart, through the heart’s valves and flow of air through the
upper and lower airways and in the lungs which generate typical acoustic signal.
Biomechanical Signals: These signals originate from some mechanical function of the
biological system. They include all types of motion and displacement signals, pressure and
flow signals etc. The movement of the chest wall in accordance with the respiratory activity
is an example of this type of signal.
Biochemical Signals: The signals which are obtained as a result of chemical measurements
from the living tissue or from samples analyzed in the laboratory. The examples are
measurement of partial pressure of carbon-dioxide (pCO2), partial pressure of oxygen (pO2)
and concentration of various ions in the blood.
Biomagnetic Signals: Extremely weak magnetic fields are produced by various organs such
as the brain, heart and lungs. The measurement of these signals provides information which is
not available in other types of bio-signals such bio-electric signals. A typical example is that
of magneto-encephalograph signal from the brain.
Bio-optical Signals: These signals are generated as result of optical functions of the
biological systems, occurring either naturally or induced by the measurement process. For
example, blood oxygenation may be estimated by measuring the transmitted/back scattered
light from a tissue at different wavelengths.
Bio-impedance Signals: The impedance of the tissue is a source of important information

concerning its composition, blood distribution and blood volume etc. The measurement of
galvanic skin resistance is a typical example of this type of signal. The bio-impedance signal
is also obtained by injecting sinusoidal current in the tissue and measuring the voltage drop
generated by the tissue impedance. The measurement of respiration rate based on bio-
impedance technique is an example of this type of signals.
2.2: Origin of Bioelectric Signals
The association of electricity with medical science dates back to the 18th century when
Galvani demonstrated that most of the physiological processes were accompanied with
electrical changes. This discovery formed the basis of the explanation of the action of living

tissues in terms of bioelectric potentials. It is now well established that the human body,
which is composed of living tissues, can be considered as a power station generating multiple
electrical signals with two internal sources, namely muscles and nerves.
Normal muscular contraction is associated with the migration of ions which generates
potential differences measurable with suitably placed electrodes. For example, the heart and
the brain produce characteristic patterns of voltage variations which when recorded and
analyzed are useful in both clinical practice and research. Potential differences are also
generated by the electrochemical changes accompanied with the conduction of signals along
the nerves to or from the brain. These signals are of the order of a few microvolts and give
rise to a complicated pattern of electrical activity when recorded. The fact that the activity of
the living tissues is due to the potential changes in them suggested the use of external
electricity for the diagnosis of certain diseases affecting muscles and nerves, for the
augmentation or replacement of a deficient natural activity or for the restoration of a palsied
muscle.
Bioelectric potentials are generated at a cellular level and the source of these potentials is
ionic in nature. A cell consists of an ionic conductor separated from the outside environment
by a semipermeable membrane which acts as a selective ionic filter to the ions. This means
that some ions can pass through the membrane freely where as others cannot do so. All living
matter is composed of cells of different types. Human cells may vary from 1 micron to 100
microns in diameter, from 1 mm to 1 m in length, and have a typical membrane thickness of
0.01 micron (Peter Strong, 1973). Surrounding the cells of the body are body fluids, which
are ionic and which provide a conducting medium for electric potentials. The principal ions
involved with the phenomena of producing cell potentials are sodium (Na+), potassium (K+)
and chloride (Cl–). The membrane of excitable cells readily permits the entry of K+ and Cl–
but impedes the flow of Na+ even though there may be a very high concentration gradiant of
sodium across the cell membrane. This results in the concentration of the sodium ion more on
the outside of the cell membrane than on the inside. Since sodium is a positive ion, in its
resting state, a cell has a negative charge along the inner surface of its membrane and a
positive charge along the outer portion.
The unequal charge distribution is a result of certain electrochemical reactions and processes
occurring within the living cell and the potential measured is called the resting potential. The

cell in such a condition is said to be polarized. A decrease in this resting membrane potential
difference is called depolarization..
Fig. 2.1 A typical cell potential waveform
The distribution of positively charged ions on the outer surface and negatively charged
ionsinside the cell membrane results in the difference of potential across it and the cell
becomes,in effect, a tiny biological battery. Experiments have shown that the internal resting
potentialwithin a cell is approximately –90 mV with reference to the outside of the cell.
When the cellis excited or stimulated, the outer side of the cell membrane becomes
momentarily negativewith respect to the interior. This process is called depolarization and the
cell potential changes to approximately +20 mV. Repolarization then takes place a short time
later when the cell regains its normal state in which the inside of the membrane is again
negative with respect to the outside. Repolarization is necessary in order to re-establish the
resting potential. This discharging and recharging of the cell produces the voltage waveforms

which can be recorded by suitable methods using microelectrodes. A typical cell potential
waveform so recorded is shown in Fig. 2.1
Fig. 2.2 Electrical activity associated with one contraction in a muscle
The wave of excitation while propagating in the muscle causes its contraction. The
contraction wave always follows the excitation wave because of its lower velocity. This
phenomenon is found with the skeletal muscles, the heart muscle and the smooth muscles. In
its turn, every contraction (movement) of a muscle results in the production of an electric
voltage. This voltage occurs in the muscle in such a way that the moving muscle section is
always negative with respect to its surroundings. These voltages are called action potentials
because they are generated by the action of the muscles. After complete contraction,
repolarization takes place resulting in the relaxation of the muscle and its returning to the
original state. Figure 2.2 shows electrical activity associated with one contraction in a muscle
The currents involved in bioelectricity are unlike the currents involved in electronics.
Bioelectric currents are due to positive and negative ion movement within a conductive fluid.
The ions possess finite mass and encounter resistance to movement within the fluid for they
have limited speeds.

The cell action potential, therefore, shows a finite rise time and fall time. It may be noted that
a cell may be caused to depolarize and then repolarize by subjecting the cell membrane to an
ionic current. However, unless a stimulus above a certain minimum value is applied, the cell
will not be depolarized and no action potential is generated. This value is known as the
stimulus threshold. After a cell is stimulated, a finite period of time is required for the cell to
return to its pre-stimulus state. This is because the energy associated with the action potential
is developed from metabolic processes within the cell which take time for completion. This
period is known as refractory period.
The bioelectric signals of clinical interest, which are often recorded, are produced by the
coordinated activity of large groups of cells. In this type of synchronized excitation of many
cells, the charges tend to migrate through the body fluids towards the still unexcited cell
areas. Such charge migration constitutes an electric current and hence sets up potential
differences between various portions of the body, including its outer surface. Such potential
differences can be conveniently picked up by placing conducting plates (electrodes) at any
two points on the surface of the body and measured with the help of a sensitive instrument.
These potentials are highly significant for diagnosis and therapy. The primary characteristics
of typical bioelectric signals are given in Table 2.1.
2.3 : Electrocardiogram (ECG)
The recording of the electrical activity associated with the functioning of the heart is known
as electrocardiogram. ECG is a quasi-periodical, rhythmically repeating signal synchronized

The process of recording the change in potential when light falls on the eye is called
electroretinography.
ERG potentials can be recorded with a pair of electrodes. One of the electrodes is mounted on
a contact lens and is in direct contact with the cornea.
Polarizable and Non-Polarizable Electrodes
Perfectly Polarizable Electrodes: These are electrodes in which no actual charge crosses the
The other electrodeinterface
electrode-electrolyte is placedwhen
on the skin adjacent
a current to the
is applied. Theouter corner
current ofthe
across theinterface
eye. A reference
is a
displacement current and the electrode
electrode may be placed on the forehead.behaves like a capacitor. Example : Ag/AgCl Electrode
Perfectly Non-Polarizable Electrode: These are electrodes where current passes freely across the
electrode-electrolyte interface, requiring no energy to make the transition.
A general purpose direct writing recorder may be used for recording electroretinograms.
Example: Ag-AgCl is used in recording while Pt is use in stimulation
The magnitude of the ERG voltage depends upon the intensity and duration of the light
falling on the eye. It may be typically about 500 mV.
2.8: Recording Electrodes–Electrode-tissue interface,

Bioelectric events have to be picked up from the surface of the body before they
can be put into the amplifier for subsequent record or display. This is done by
using electrodes.
Electrodes make a transfer from the ionic conduction in the tissue to the
electronic conduction which is necessary for making measurements.
Two types of electrodes are used in practice-surface electrodes and the deep-
seated electrodes. The surface electrodes pick up the potential difference from
the tissue surface when placed over it without damaging the live tissue.
2.8.1 ELECTRODE TISSUE INTERFACE
The most commonly used electrodes in patient monitoring and related studies are surface
electrodes. The notable examples are when they are used for recording ECG, EEG and
respiratory activity by impedance pneumography.
In order to avoid movement artefacts and to obtain a clearly established contact (low contact
impedance) an electrolyte or electrode paste is usually employed as an interface between the

electrode and the surface of the source of the event. Figure 2.7 (a, b) represent the electrode-
tissue interface.
The characteristic of a surface electrode composed of a metal electrode and attached to the
surface of the body through an electrolyte (electrode jelly) are dependent upon the conditions
at the metal-electrolyte interface, the electrolyte-skin interface and the quality of the
electrolyte.
Metal-Electrolyte Interface:
At the metal-electrolyte transition, there is a tendency for each electrode to discharge ions
into the solution and for ions in the electrolyte to combine with each electrode. The net result
is the creation of a charge gradient (difference of potential) at each electrode, the spatial
arrangement of which is called the electrical double layer (Fig. 2.7(c)). The double layer is
known to be present in the region immediately adjacent to the electrode and can be
represented, in its simplest form, as two parallel sheets of charge of opposite sign separated
by a thin film of dielectric. Therefore, the metal-electrolyte interface appears to consist of a
voltage source in series with a parallel combination of a capacitance and reaction resistance.
The voltage developed is called the half-cell potential.

Electrolyte-Skin Interface:
An approximation of the electrolyte-skin interface can be had by assuming that the skin acts
as a diaphragm arranged between two solutions (electrolyte and body fluids) of different
concentrations containing the same ions, which is bound to give potential differences.
The simplest equivalent representation could then be described as a voltage source in series
with a parallel combination of a capacitance and resistance. The capacitance represents the
charge developed at the phase boundary whereas the resistance depends upon the conditions
associated with ion-migration along the phase boundaries and inside the diaphragm.
The above discussion shows that there is a possibility of the presence of voltages of
Non physiological origin. These voltages are called contact potentials.

The electrical equivalent circuit of the surface electrode suggests that the voltage presented to
the measuring instrument from the electrode consists of two main components. One is the
contact potential and the other is the biological signal of interest.
The contact potential depends upon several factors and may produce an interference signal
which exceeds several times the useful signal. The contact potential is found to be a function
of the type of skin, skin preparation and composition of the electrolyte.
The electrodes are used to measure a bioelectric event and are connected to a differential
amplifier. Three potentials are found to exist in this circuit (Fig. 2.9), one is due to the
bioelectric event (Eb) and the other two are non-physiologicand represent the half-cell
potentials (E1 and E2) of the electrodes. Z1 and Z2 are the skin contact impedances of these
electrodes and R is the tissue resistance or resistance of the bioelectric generator.
This circuit shows that the impedance of the electrodes would be high in the low frequency
region and it would decrease with increasing frequency. It is further clear that in the
measurement of a bioelectric signal, it is essential to minimize potential drops across the
electrode impedance. This is achieved by making the skin-contact impedance as low as
possible and making the input impedance of the measuring device as high as possible.

POLARISATION
If a low voltage is applied to two electrodes placed in a solution, the electrical double layers
are disturbed. Depending on the metals constituting the electrodes, a steady flow of current
may or may not take place.

In some metal/liquid interfaces, the electrical double layer gets temporarily disturbed by the
externally applied voltage, and therefore, a very small current flows after the first surge, thus
indicating a high resistance. This type of electrode will not permit the measurement of steady
or slowly varying potentials in the tissues.
They are said to, be polarized or nonreversible. Thus, the phenomenon of polarization affects
the electro-chemical double layer on the electrode surface and manifests itself in changing the
value of the impedance and voltage source representing the transition layer.
Parsons (1964) stated that electrodes in which no net transfer of charge takes place across the
metal-electrolyte interface can be termed as perfectly polarized. Those in which unhindered
exchange of charge is possible are called non-polarizable or reversible electrodes. The ionic
double layer in metals of these electrodes is such that they allow considerable current to flow
when a small voltage is applied, thus offering a low resistance.
SKIN CONTACT IMPEDANCE :
Measurement of Skin Contact Impedance: A convenient method to measure the contact

impedance at any individual electrode is shown in Fig. 2.11.
The three electrodes, A, B and C, have contact impedance respectively of Za, Zb andZc. An
oscillator provides a constant current in the frequency range of 0.1–100 Hz through the 47
kW series resistor.
By suitably positioning the switch, a sensitive oscilloscope can be used to monitor either the
voltage dropped across the 1 kW resistor or the voltage dropped across Zb.
The voltage drop across Zb can be neglected since the input impedance of the oscilloscope
used with an input probe is usually high. From the voltage dropped across the 1 kW resistor
it is possible to calculate the circuit current and thus to obtain a value for Zc.
Using this technique, the skin contact impedance of the following types of electrodes were
measured by Hill and Khandpur (1969).

• Plastic cup self-adhesive electrodes (Boter et al, 1966)
• Metal plate limb electrodes used with conducting jelly
• Metal plate electrodes used with conducting plastic (Jenkner, 1967)
• Dry multi-point limb electrodes (Lewes, 1966)
• Dry multi-point suction chest electrodes
• Self-adhesive multi-point chest electrodes used with conducting jelly
• Self-adhesive gauze electrodes
• Self-adhesive dry multi-point chest electrodes (Lewes and Hill, 1967)
Motion Artifacts
Motion artefact is a problem in biopotential measurements. The problem is greatest in cardiac

stress laboratories where the exercise ECG is recorded. The problem is also serious in
coronary care units where patients are monitored for relatively long periods.
Motion of the subject under measurement creates artefacts which may even mask the desired
signal or cause an abrupt shift in the baseline. These artefacts may result in a display being

unreadable, a recording instrument exceeding its range, a computer yielding incorrect output
or a false alarm being triggered by the monitoring device.
Tam and Webster (1977) concluded that the skin-electrolytic paste interface is the major
source of motion artefact. When a metal electrode contacts an electrolytic paste, a half cell
potential is generated at the electrode-paste interface. Kahn (1965) demonstrated that when
polarizable metal-plate electrodes are used, the electrode-paste interface can be a source of
motion artefact.
When the paste is agitated, the half-cell potential varies because of the altered metallic ion
gradient at the interface. He recorded a 1 mV offset potential change from a silver-silver
chloride electrode exposed to a flowing stream of saline solution, as contrasted to 30 mV
change for some silver electrodes.
Motion artefact is reduced to a negligible magnitude by skin abrasion. However, when the
skin is abraided, it is more susceptible to irritants. The possible sources for skin irritation
include the electrode, the paste and the adhesive. When large currents flow through metallic
electrodes, migration of some ions into the skin can cause irritation.
2.9 Silver-Silver Chloride electrodes
Production of Silver-Silver Chloride Electrodes: Silver-silver chloride electrodes are

normally prepared by electrolysis. Two silver discs are suspended in a saline solution. The
positive pole of a dc supply is connected to the disc to be chlorided and the negative pole
goes to the other disc. A current at the rate of 1 mA/cm2 of surface area is passed through the
electrode for several minutes. A layer of silver chloride is thus deposited on the surface of the
anode. The chemical changes that take place at the anode and cathode respectively are:
To prepare silver-silver chloride electrodes of good quality, only pure silver should be used
and the saline solution should be made from analar grade sodium chloride. Before
chloriding, silver must be cleaned—preferably by the electrolytic method.

14 VSA GROUP OF INSTITUTIONS-2014
Electromyogram [EMG]: EMG is the record of electrical activity of muscles.
Typical bandwidth: 300-3000 Hz

Typical amplitude: 10-100 mV
ELECTRODES
Employed to pick up the electrical signals of the body
Pair of electrodes play the role of a transducer
Amplifier has to be designed – to accommodate the characteristics of electrodes
Type of electrode – depends on anatomical location of bioelectric event and dimensions of the
bioelectric generator
Electrical characteristics of the electrodes specify the type of preamplifier
For microelectrodes, many restrictions on the input impedance of the amplifier
Amplifier – have large impedances, high resistance and low capacitance input circuits – need to transfer
the bioelectric event to the amplifying system
Fig: EMG Waveform
ELECTRODES:
Electrodes are generally used to pick up the electric signals of the body. There
are various electrodes that are used in instrumentation system. They are
1. Surface electrode
2. Micro electrode
3. Depth electrode
4. Needle electrode
5. Chemical electrode
MEDICAL ELECTRONICS LECTURE NOTES © Ms.V.Ezhilya,AP/ECE

TYPES OF ELECTRODES:
1. Micro-Electrodes:
They are normally used to measure the potential within a single cell.
The microelectrodes are very small in diameter and so it will not

damage the human cell.
Microelectrodes are classified into Metallic & Non-Metallic.
Metallic Electrode:
The metal microelectrodes are formed by electrolytically etching the tip

of fine tungsten filament into a minute structure.
The final potential within the cell is the difference between the
microelectrode potential and reference potential.
Final potential = EA-ER
Micropipet:
It is used to measure the potential within a single cell, but instead of metal
electrolyte non-metallic material is used.

2. Depth Electrode:
Depth electrodes are used to measure the oxygen tension.
These are used to study the electrical activity of neuron of superficial layers
of brain.
In some depth electrode, the supporting element is in the form of capillary

tube, which is used to inject medicine into the brain.
3. Needle Electrode:
Needle electrodes are used to record the peripheral nerve action potential.
The needle electrode will resemble a medicine dropper. There are two
types:
1. Monopolar needle electrode.
2. Bipolar needle electrode.
4. Surface Electrode:
The surface electrodes are used to measure the potential available from the
surface of the skin and used to sense the potential from heart, brain and
nerves.

The smaller area surface electrodes are used to measure EEG,EMG

potentials and the larger area surface electrodes are used to measure ECG
potentials.
Depends on construction, the surface electrodes are classified into
1. Metal plate electrode
2. Suction cup electrode
3. Adhesive tape electrode
4. Multipoint electrode
5. Floating electrode
1. Metal plate electrode:

It is made up of Ag-AgCl (Silver-Silver Chloride). It is used to pick up ECG from
the limb lead positions. It is fixed to the skin surface by means of conductive gel &
rubber belt.
Fig: Metal plate electrode.
2. Metal disc electrode:

It is made up of Ag-AgCl. It is used to pick up EEG from the scalp. It is fixed to the
scalp by means of adhesive tape.

Fig: Metal disc electrode.
3. Metallic suction electrode:

It is made up of Ag-AgCl. It is used to pick up ECG from chest lead positions and
EMG from muscular areas such as calf, thigh etc. It does not require adhesive tapes
or rubber bands. It is fixed to the skin surface by means of air suction.
Fig: Metal suction electrode.
4. Disposable foam-pad electrode:

It is made up of Ag-AgCl. It is used to pick up ECG or EEG for those patients with
contagious skin diseases. It is fixed to the skin surface by means of adhesive tapes
attached to the electrode.
Fig: Disposable foam-pad electrode.
5. Floating electrode:
This type of electrode is used to prevent the motion-artifact from being picked up.

Fig: Floating electrode.
5. Chemical electrodes:
The chemical electrodes are used to measure the pH content and pO 2 of

blood. It is also used to determine the oxygen content & CO 2 content in
blood.
Various types of chemical electrodes are
1. Hydrogen electrode.
2. Practical reference electrode.
3. pH electrode.
4. pO2 electrode.
5. pCO2 electrode.
Possible Questions:
1. Define the process of depolarization & repolarization.[2m]
2. What is the specific usage of signal average? [2m] Books Reffered:
3. What is ERP? [2m] 1. Medical Electronics –

R.L.Rekha [Pg:No: 1.18
4. Write down the Nernst equation. [2m]
to 1.]
5. What is a PCG? [2m]
2. Handbook of
6. Write a detail note on electrodes. [16m] biomedical
instrumentation –
R.S.Khandpur

EC2021 MEDICAL ELECTRONICS
UNIT II
Non Metallic (Micropipet)
ELECTRODE CONFIGURATIONS
• characteristics
Bio signals It is used to –measure
frequencythe
andpotential
amplitudewithin
ranges.the
ECG – Einthoven’s
single triangle,
cell using standard
non metallic
12 lead system. EEG is
material – 10-20
used. electrode system, unipolar, bipolar and average mode, EMG–
unipolar•andItbipolar mode
is filled within an electrolyte ,that is compatible with the cellular fluids.
1.3 BIOPOTENTIAL AMPLIFIERS
• These are very important part of modern medical instrumentation. We need to

amplify biopotentials which are generated in the body at low levels with high
source impedance.
• Biopotentials amplifiers are required to increase signal strength while maintaining
fidelity
Basic Requirements of Biopotential Amplifiers
Essential functions of a bioamplifier are:

• To take a weak biopotential and increase its amplitude so that it can be processed,
recorded or displayed
• To amplify voltage, but it could be considered as a power amplifier as well.To amplify
current since in some cases a biopotential amplifier is used to isolate the load from the source
current gain only
Input Impedance (Zin)
• All biopotential amplifiers must have high input impedance minimize loading
(remember the characteristics of biopotential electrodes resulting into loading and distortion if
input impedance of the amplifier is not high enough) – typical values of Zin over the frequency
range of the measure and = 10 MΩ (remember the loading rule)
Protection & Isolation

• The input circuit of a biopotential amplifier must provide protection to the live measure
Vbio
• Any potential or current at amplifier’s input terminals can affect
Vbio
• Electric currents produced by the biopotential amplifier can result in microshock and
macro shock
• The bioamplifier must have isolation and protection circuitry so that the current through
the electrodes can be kept at safe levels and any artifact generated by such current can be
minimized
Output Impedance (Zout)
• The output circuit does not present any critical problems, all it needs to do is to drive the
load
• Output impedance must be low with respect to the load impedance and it must be capable
of satisfying the power requirements of the load
SCE 10 DEPT.OF ECE

Bandwidth (BW)
Frequency response
• The biopotential amplifier must be sensitive to important frequency components of the
biosignal
• Since biopotentials are low level signals, it is important to limit bandwidth optimize
signal-to-noise ratio
Gain (G)
• Biopotential amplifiers have a gain of 1000 or greater
Mode of Operation
• Very frequently biosignals are obtained from bipolar electrodes
• Electrodes symmetrically located with respect to ground need differential amplification
• High CMRR required because:
1. Common mode signals much greater than the biosignal appear on bipolar electrodes
2. Symmetry with respect to ground is not perfect (mismatch between electrode impedances) –
more on this later
Calibration Signal
• Medical and clinical equipment require quick calibration. The gain of the biopotential
amplifier must be calibrated to provide us with an accurate indication of the signal’s
amplitude
• Push button to apply standard signal to the input of the biopotential amplifier
• Adjustable gain switch carefully selects calibrated fixed gains.
1.4 ELECTROCARDIOGRAPHY (ECG)
• A very widely used medical instrument, which is utilized to diagnose and monitor cardiac
beat abnormalities, is the electrocardiograph.
• It measures the electrical activity of the heart (more precisely biopotential differences
arising from the electrical activity of myocardium). We’ve already talked about the
genesis of the ECG signal.
• The ECG machine uses surface electrodes and high input impedance
• Differential amplifiers with good common mode rejection ratio to record the
electrocardiogram
• Normal ECG amplitude ranges between 0.5-4 mV. Normal frequency content of ECG
(for diagnostic purposes) is 0.05-100 Hz. A typical ECG waveform is shown below:
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The Electrical and Mechanical Sequence of a Heartbeat
The heart has specialized pacemaker cells that start the electrical sequence of depolarization and
repolarization. This property of cardiac tissue is called inherent rhythmicity or automaticity.
The electrical signal is generated by the sinoatrial node (SA node) and spreads to the ventricular
muscle via particular conducting pathways: intermodal pathways and atrial fibers, the
atrioventricular node (AV node,) the bundle of His, the right and left bundle branches, and
Purkinje fibers
When the electrical signal of a depolarization reaches the contractile cells, they contract—a
mechanical event called systole. When the repolarization signal reaches the myocardial cells, they
relax—a mechanical event called diastole. Thus, the electrical signals cause the mechanical
pumping action of the heart; mechanical events always follow the electrical events.
The SA node is the normal pacemaker of the heart, initiating each electrical and mechanical cycle.
When the SA node depolarizes, the electrical stimulus spreads through atrial muscle causing the
muscle to contract. Thus, the SA node depolarization is followed by atrial contraction.
The SA node impulse also spreads to the atrioventricular node (AV node) via the inter nodal
fibers. (The wave of depolarization does not spread to the ventricles right away because there is
non conducting tissue separating the atria and ventricles.) The electrical signal is delayed in the
AV node for approximately 0.20 seconds when the atria contract, and then the signal is relayed to
the ventricles via the bundle of His, right and left bundle branches, and Purkinje fibers.
The Purkinje fibers relay the electrical impulse directly to ventricular muscle, stimulating the
ventricles to contract (ventricular systole). During ventricular systole, ventricles begin to
repolarize and then enter a period of diastole.
Although the heart generates its own beat, the heart rate (beats per minute or BPM) and strength
of contraction of the heart are modified by the sympathetic and parasympathetic divisions of the
autonomic nervous system.
• The sympathetic division increases automaticity and excitability of the SA node, thereby
increasing heart rate. It also increases conductivity of electrical impulses through the
atrioventricular conduction system and increases the force of atrioventricular contraction.
Sympathetic influence increases during inhalation.
• The parasympathetic division decreases automaticity and excitability of the SA node, thereby
decreasing heart rate. It also decreases conductivity of electrical impulses through the
atrioventricular conduction system and decreases the force of atrioventricular contraction.
Parasympathetic influence increases during exhalation.
The average resting heart rate for adults is between 60-80 beats/min. (Average 70 bpm for males
and 75 bpm for females.) Slower heart rates are typically found in individuals who regularly
exercise. Athletes can pump enough blood to meet the demands of the body with resting heart rates
as low as 50 beats/min. Athletes tend to develop larger hearts, especially the muscle in the left
ventricle—a condition known as “left ventricular hypertrophy.” Because athletes (usually) have
larger and more efficient hearts, their ECGs may exhibit differences other than average resting
heart rate. For instance, low heart rate and hypertrophy exhibited in sedentary individuals can be
an indication of heart failure, but these changes are “normal” for well-trained athletes.
ECG Activity
Just as the electrical activity of the pacemaker is communicated to the cardiac muscle, “echoes” of
the depolarization and repolarization of the heart are sent through the rest of the body. By placing
a pair of very sensitive receivers (electrodes) on other parts of the body, the echoes of the heart’s
electrical activity can be detected. The record of the electrical signal is called an
electrocardiogram (ECG).
The ECG represents electrical events of the cardiac cycle whereas Ventricular Systole and
Ventricular Diastole represent mechanical events (contraction and relaxation of cardiac muscle,
passive opening and closing of intracardiac valves, etc.).
Electrical events occur quickly, mechanical events occur slowly. Generally, mechanical events
follow the electrical events that initiate them. Thus, the beginning of ventricular diastole is
preceded by the beginning of ventricular depolarization. In fact, in a normal resting Lead II,
ventricular repolarization normally begins before the completion of ventricular systole in the same
cardiac cycle. That is why the end of ventricular systole/beginning of ventricular diastole is marked
in about 1/3 of the way down the T-wave.
Because the ECG reflects the electrical activity, it is a useful “picture” of heart activity. If there
are interruptions of the electrical signal generation or transmission, the ECG changes. These
changes can be useful in diagnosing changes within the heart.
Components of the ECG
The electrical events of the heart (ECG) are usually recorded as a pattern of a baseline (isoelectric
line,) broken by a P wave, a QRS complex, and a T wave. In addition to the wave components of
the ECG, there are intervals and segments.
• The isoelectric line is a point of departure of the electrical activity of depolarizations and
repolarizations of the cardiac cycles and indicates periods when the ECG electrodes did not detect
electrical activity.
• An interval is a time measurement that includes waves and/or complexes.
• A segment is a time measurement that does not include waves and/or complexes.
Components of the ECG (Lead II) & Electrical and mechanical events of the cardiac cycle
Table 1 Components of the ECG & Typical Lead II Values*
Leads
The particular bipolar arrangement of two electrodes (one positive, one negative) with respect to
a third electrode (the ground) is called a lead. The electrode positions for the different leads have
been standardized. Typical Lead II values are shown above in Table.
The dominant ECG component in any normal standard lead record is the QRS complex. Usually,
in a Lead II recording the Q and S waves are small and negative and the R wave is large and
positive as shown in Fig. However, it is important to note many factors, normal and abnormal,
determine the duration, form, rate, and rhythm of the QRS complex.
▪ Normal factors include body size (BSA) and distribution of body fat, heart size (ventricular
mass,) position of the heart in the chest relative to lead locations, metabolic rate, and others.
For example, in a person who has a high diaphragm, the apex of the heart may be shifted slightly
upward and to the person’s left. This change in the position of the heart alters the “electrical
picture” of ventricular depolarization seen by the Lead II electrodes, resulting in decreased
positivity of the R wave and increased negativity of the S wave. In other words, the positive
amplitude of the R wave decreases and the negative amplitude of the S wave increases.
Similar changes in the Lead II QRS complex may be observed in a person, an athlete for example,
who has no cardiac disease but does have a larger than normal left ventricular mass. In fact the
decrease in R wave positivity coupled with the increase in S wave negativity may be so extreme
as to give rise to the mistaken impression that the R wave has become inverted, when in reality the
inverted spike is an enlarged S wave preceded by a much smaller but still positive R wave. When
the amplitudes of Lead II Q, R, and S waves are all negative, the result is an abnormal inverted
QRS complex.
Significant diagnostic features of the ECG signal are:
• Duration of component parts of the signal

• Polarities and magnitudes
• The details of the ECG signal and the degree of variability in different parts of the ECG
signal is shown below:
Figure 1.13 ECG Signal
• The QRS amplitude, polarity, time duration, the RR interval (indicator of heartbeat per
min.) and the T-wave amplitude are some very important and distinctive features of the
ECG signal.
• The heart rate in BPM = Beats Per Minute) is simply = 60 (RR interval in seconds)
Some ECG waveform abnormalities that may indicate illness are:
• An extended PR interval may be diagnosed as AV node block

• A widening of the QRS complex may indicate conduction problems in the bundle of His
• An elevated ST segment may indicate occurrence of myocardial Infarction (MI)
• A negative polarity in the T wave may be due to coronary insufficiency
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1.4.1 ECG Leads
A Normal ECG recording for the standard lead connections leads I, II and III (Lead II
provides the strongest signal)
Figure 1.14 Normal ECG waveforms
Obviously, all human hearts are not the same and this results into a high degree of variability.
Some abnormalities that may indicate illness:
• An extended P-R interval may be diagnosed as AV node block

• Widening of the QRS complex conduction problems in the bundle of His
• Elevated ST segment may indicate occurrence of MI
• Negative polarity T wave may be due to coronary insufficiency QRS amplitude, polarity,
time domain, PR interval (indicator of heat beat per min. & T-wave amplitude are some
very important.
• Distinctive features.
1.Loss
Figure 1.15 ECG Abnormal waveforms
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2. Origin of the ECG signal
• We have already covered this concept extensively in the previous lectures (The Dipole
filed of the heart, the Eindhoven’s Triangle, the electrical circuit model for the
electrocardiographic problem, etc.)
Standard Limb Leads (I, II, III)
Figure 1.16 origin of ECG Signal
• The lead wires are color-coded according to some conventions. One example is: White –
RA (Right Arm), Black – LA (Left Arm), Green – RL (Right Leg), Red – LL (Left Leg),
and Brown – C (Chest)
Augmented Limb Leads
• These leads offer a free 50% increase over leads VR, VL, and VF connections (unipolar
leads) with respect to Wilson terminal AVR = -I – III/2, AVL = I – II/2, aVF = II – I/2
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Figure 1.17 Augmented Limb Leads
Each measurement is made from the reflected limb and the average of the other two limbs.
1.4.2 The ECG Machine

Most representative Specs:
• Zin = 10 MΩ
• Frequency response = 0.05 –100 Hz
• Strip Chart Recorder Speed = 25 mm/sec.
• Fast Speed = 100 mm/sec.
For detailed Specs. Refer to the Table in your text “Summary of performance requirements
for electrocardiographs”
Location of the Heart
• The heart is located between the lungs behind the sternum and above the diaphragm.
• It is surrounded by the pericardium.
• Its size is about that of a fist, and its weight is about 250-300 g.
• Its center is located about 1.5 cm to the left of the midsagittal plane.
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Figure 1.18 Location of Heart
Anatomy of the heart

• The walls of the heart are composed of cardiac muscle, called myocardium.
• It consists of four compartments:
– the right and left atria and ventricles
The Heart Valves

• The tricuspid valve regulates blood flow between the right atrium and right ventricle.
• The pulmonary valve controls blood flow from the right ventricle into the pulmonary
arteries
• The mitral valve lets oxygen-rich blood from your lungs pass from the left atrium into the
left ventricle.
• The aortic valve lets oxygen-rich blood pass from the left ventricle into the aorta, then to
the body.
Figure 1.19 Heart Valves
Blood circulation via heart

• The blood returns from the systemic circulation to the right atrium and from there goes
through the tricuspid valve to the right ventricle.
• It is ejected from the right ventricle through the pulmonary valve to the lungs.
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• Oxygenated blood returns from the lungs to the left atrium, and from there through the
mitral valve to the left ventricle.
• Finally blood is pumped through the aortic valve to the aorta and the systemic
circulation.
Electrical activation of the heart
• In the heart muscle cell, or myocyte, electric activation takes place by means of the same
mechanism as in the nerve cell, i.e., from the inflow of Na ions across the cell membrane.
• The amplitude of the action potential is also similar, being 100 mV for both nerve and
muscle
• The duration of the cardiac impulse is, however, two orders of magnitude longer than in
either nerve cell or sceletal muscle cell.
• As in the nerve cell, repolarization is a consequence of the outflow of K ions.
• The duration of the action impulse is about 300 ms
Mechanical contraction of Cardiac Muscle
• Associated with the electric activation of cardiac muscle cell is its mechanical
contraction, which occurs a little later.
• An important distinction between cardiac muscle tissue and skeletal muscle is that in
cardiac muscle, activation can propagate from one cell to another in any direction.
• Electrical signal begins in the sinoatrial (SA) node: "natural pacemaker." causes the atria
to contract.
• The signal then passes through the atrioventricular (AV) node.
– sends the signal to the ventricles via the “bundle of His”
– Causes the ventricles to contract.
The Conduction System
Figure 1.20 Conduction System
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The Action Potential
Figure 1.21 Action Potential
Recording an AP requires the isolation of a single cell.
• Microelectrodes (with tips a few μm across) are used to stimulate and record the
response. A typical AP is 2-4ms long with an amplitude of about 100Mv
1.5 ELECTROENCEPHALOGRAM (EEG)
• EEG is the recorded representation of bioelectric potentials generated by the neuronal

activity of the brain.
• Basically, the brain is a gelatinous mass suspend in the meanings, the cerebrospinal fluid,
skull and scalp.
• The brain is composed of three major subdivisions:
1. Cerebellum,
2. Brainstem
3. (Medulla, pons, midbrain, diencephalon) and
4. Cerebrum
The cerebellum is mainly involved with skeletal muscle functions and maintenance of balance. It
coordinates smooth and directed movements.
• The brain stemis the stalk of the brain and serves as a relay station for all afferent
(sensory) and efferent (motor) nerve fibers between the spinal cord and higher brain
canters. It also gives rise to ten of the twelve cranial nerves, which supply the muscles and
glands of the head and major organs in the thoracic and abdominal cavities
• Throughout the entire brainstem runs a core of tissue called the reticular formation, which
serves as a highly complex cluster of neurons involved in integration of information from
many afferent pathways as well as from numerous other parts of the brain.
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• The cerebrum consists of the right and left hemispheres. The outer part of the cerebral
hemispheres, the cerebral cortex, is a cellular shell 1.5 – 4 mm thick of grey matter.
• The cerebral cortex is highly convoluted and is the most complex integrating center of the
nervous system. It brings together basic sensory information into meaningful perceptual
images and formulates ultimate decisions for control over the motor systems of the body.
• The cerebral cortex is comprised of two layers: the pale cortex and the neocortex.
• The pale cortex is located on the median surface and the base of the brain and the
neocortex is present on the superior and lateral aspects of the cerebral hemispheres.
• The neocortex is composed of six layers and its cells can be categorized as pyramidal and
non-pyramidal cells. There are approximately 1010 neurons in the human cerebral cortex,
about 75% of, which is pyramidal.
• Pyramidal cells, named originally after their shape, have several
characteristics. Their cell bodies are commonly triangular in shape, with the base down
and the apex directed toward the cortical (superficial) surface.
• The cell bodies vary in size, from axial dimensions of 15 x 10 μm up to 120 x 90 μm. A
typical pyramidal cell consists of a long apical dendrite, about 2 mm long, that ascends
from the apex of the cell body and enters the overlaying layers and terminally branches
within the outermost layer of the neocortex.
• There is a dominant apical dendrites tree, looking like a forest of
similarly oriented, densely packed units in the superficial layers of the neocortex, where
extensive branching occurs.
Figure 1.22 EEG

• There is also a basilar dendritic system that extends out spherically from the cell body.
• Pyramidal cells also have an axon that emerges from the cell body and enters the sub
cortical white matter.
• The axons of all pyramidal cells terminate in excitatory synapses. The initial segment of
pyramidal cells is unmyelinated,as their recurrent branches
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• Axons of some pyramidal cells turn back toward the cortical surface to end via their many
dendritic branches on the dendrites of other cells.
• It has been shown by electrophysiological studies that under normal circumstances,
propagating action potentials in axons do not contribute significantly to surface cortical
recordings.
• There reason being that action potentials travel in large number of axons (running in
many different directions relative to the surface) in a temporally a synchronized way.
Therefore, their net contribution to the surface EEG is minimal and negligible.
• It has been shown that the vertically oriented pyramidal cells with their long apical
dendrites running parallel to one another are the major contributors to the electro genesis
of the cortical field potentials (EEG signal).
Figure 1.23 Cerebrum
A highly schematic representation of a pyramidal cell and its role in the generation of surface
EEG signal. Let’s consider a single pyramidal cell, and explain how potential changes in one part
of the cell relative to other parts could generate the EEG signal.
• Excitatory synaptic inputs to the branches in the apical dendritic tree of the pyramidal
cells cause depolarization of the dendritic membrane.
• This leads into generation of an excitatory postsynaptic potential (EPSP)
• As a result, a radially oriented dipole is set up and sub threshold current flows in a closed
path through the cytoplasmic core of the dendrites and cell body of the cell, returning to
the synaptic sites via the conducting extracellular medium
• The lines of current flow make the extracellular medium close to the cell body act as a
source with + polarity and the upper part of the apical dendritic tree to act as a sink with –
polarity.
• This leads into recording a negative potential at the cortical surface
• In case of inhibitory synaptic inputs to the branches in the apical
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dendritic tree, an inhibitory postsynaptic potential (IPSP) is generated with a reversal in

the polarity of the current dipole, which leads into a generation of a positive cortical
recording.
• Therefore, the influence of a particular dendritic postsynaptic potential on the cortical
recording depends on its net excitatory or inhibitory effect and on its location relative to
the measurement site.
The EEG (electroencephalogram) signal is a recording of the electrical activity of the brain.
The EEG signal recorded at the cortex or the scalp is generated by the polled activity of billions
of cortical and sub cortical regions. The origin of the EEG signal is based on the electrical
activity of the pyramidal cells. The EEG potentials primarily reflect the summated fluctuations of
excitatory and inhibitory postsynaptic potentials in the pyramidal cells of the upper layers of the
cerebral cortex. For reasons of geometry as well as because of extreme extracellular attenuation,
action potentials from firings of pyramidal cells contribute only minimally or not all to the
generation of the EEG signal.
• All we need to contend ourselves with at this stages that the EEG or brain waves are
summation of neural depolarization sin the brain due to the stimuli from the five senses as
well as from thought processes (indeed a very complex source). More on this in
physiology in the Nervous System topic.
• EEG potentials have random-appearing waveforms with peak-to-peak amplitudes ranging
from less than 10 mV to over 100mV. Required bandwidth is from below 1 Hz to over
100 Hz.
EEG is recorded with 3 types of electrodes:

1. Scalp
2. Cortical Electrocardiogram (recording from surface of cortex)
3. Depth Electrodes recording from depth of brain (thin insulated needles of various designs)
• No matter where the recording is obtained from (scalp, cortex or depth of the brain), the
fluctuating potentials represent a superposition of the volume conductor fields produced
by a huge variety of active neuronal current-generators.
• On the surface of the brain (i.e. Electrocardiogram), we can record voltages on the order
of 10 mV! But, typical EEG electrodes measure the electrical activity propagated through
skull bone and is attenuated from 1 to 100 μV.
• EEG potentials vary as a function of position over the surface of the skull, making it
necessary to select sets of electrodes grouped around Frontal, Parietal, Temporal and
Occipital lobes.
The EEG Signal
• The character of the EEG signal is highly dependent on the degree of the activity of the
cerebral cortex, i.e. waves change markedly between states of wakefulness and sleep.
• Much of the time, EEGs are irregular and no general pattern can be observed. Other
times, distinct patterns emerge
• The EEG waveform is divided into four wave groups:
1. The Alpha Waves (α) 8-13 Hz
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2. The Beta Waves (β) 14-30 Hz (The Gamma Waves (γ) 22-30 Hz or higher)
3. The Theta Waves (θ) 4-7 Hz
4. The Delta Waves (δ) <3.5 Hz
Note: During periods of mental activity, the waves usually become asynchronous rather than
synchronous, so the magnitude of summed potentials decreases in spite of cortical activity.
• In general there is a relationship between cerebral activity and the frequency of the EEG
rhythm
• Frequency increases progressively with higher degrees of activity
Figure 1.24 EEG waveform
Examples:
• δ-Waves(<3.5 Hz) occur in surgical anesthesia and sleep

• θ-Waves(4-7 Hz) occur in emotional stress and frustration
• α-Waves(8-13 Hz) occur during relaxed states
• β-Waves(14-30 Hz)occur during intense mental activity
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Figure 1.25 Different EEG waveforms
The EEG changes that occur as a human subject goes to sleep.
EEGs in Diagnosis
The purpose of the clinical EEG is to help neurologists diagnose disease. The pathological
states most commonly diagnosed using EEG are:
• Brain death (legal death)

• Brain tumors
• Epilepsy
• Multiple Sclerosis
• Sleep Disorder
• Evoked responses (diseases of the audio, visual and tactile senses)
• Modern life sustaining equipment like respirators, kidney dialyzers, ventilators, artificial
heart pumps have changes the definition of death
• A sustained absence of EEG signal is a clinical measure of brain death and can be used in
deciding whether to transplant a heart, liver, or lung or whether to shut down the life
sustaining equipment
Some Representative Abnormal EEGS
Petit mal epilepsy– Minor for of seizure, clouding of consciousness and loss of contact with the
environment
Grand mal epilepsy– Sudden loss of consciousness, falling down, tonic contractions (stiffening
of muscles) followed by twitching and jerking movements of the limbs
Psychomotor seizures are parietal seizures characterized by: semi-purposeful movements,

changes in consciousness, hallucinations and illusions.
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Figure 1.26 Abnormal EEGs
EEG Electrode Positions
• In electroencephalography, the electrodes are placed in an arrangement referred to as the

10-20 system
• This is a placement scheme devised by the International Federation of Societies of
Electroencephalography
• The electrodes are placed along a line drawn on the skull from the root of the nose, the
nasion, to the classification (bump on the occipital lobe)
• The first mark is placed 10% of the distance along this line and others are arranged at
20% intervals
Figure 1.27 EEG Electrode position

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Electroencephalograph Signal Path
The EEG signal path is comprised of: Scalp (biosignal source) EEG electrodes , Junction
box ,channel selector , differential amplifier, bank filters, display .
Figure 1.28 Block diagram of Electroencephalograph Signal Path
• It shows the modern 8 channel EEG recorder. The patient cable consists of 21 electrodes
and is connected to the 8 channel selector.
• The electrodes are attached to the channel selector in groups of 8 called a montage of
electrodes.
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• The right ear electrode acts as reference electrode for the right brain electrodes and left
ear electrode act as reference electrode for left brain electrodes.
• The 50 Hz interference is reduced by employing differential amplifiers as preamplifiers
with more than 80 dB CMRR and by use of 50 Hz notch filters.
• The effect of notch filter on signal distortion is not so much because important EEG
signals have frequencies below 30 Hz.
• The output voltage from the amplifier may either be applied directly to the eight channel
display through the filter bank or it may be stored as data on a tape recorder or in a
computer memory for further processing.
1.6 EMG (ELECTRO MYOGRAPH)
It is an instrument used for recording the electrical activity of the muscles to determine
whether the muscle is contracting or not. Study of neuromuscular function is also possible by
using EMG. Muscular contractions are caused by the depolarization of muscle fibers. Similarly
the recording of peripheral nerves action potentials is called as electro neurography.
ELECTRODES USED FOR EMG
Two types of electrodes:
Surface electrodes- Usually this electrode is used for EMG. But by using this electrode,
it is not possible to take the deeper potential.
Needle electrodes – These are inserted into tissue or closer to tissue to measure the
electrical activity of muscle.
EMG RECORDING SYSTEM
EMG potentials are taken from the tissue by using electrodes. These EMG potentials are
given to differential amplifier. This is the high gain amplifier. Its frequency range is given as 10
Hz to 10 KHz.
Bandwidth of EMG is large. CMRR (Common mode Rejection Ratio) of this differential
amplifier is 80 to 100 db.Input Impedance of this amplifier is 10 MΩ. Here there is no lead
selector switch. Because only two electrodes are available. The output of the differential
amplifier is given to loudspeaker system, tape recorder and CRO.
Before giving the output of differential amplifier to loudspeaker, it is given to power

amplifier. Power amplifier amplifies the signal that is received by loudspeaker.
The amplified signal from the output of the differential amplifier is displayed by using
CRO. Here storage oscilloscope is used. Output cab be displayed and the same can be stored in
the CRO. The signal from the differential amplifier is recorded by using tape recorder. It is used
for the future purpose.
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Figure 1.29 EMG Recording System
MEASUREMENT OF CONDUCTION VELOCITY IN MOTOR NERVES
In modern EMG systems, nerve conduction time and nerve velocity are measured. For
this measurement, initially nerve is stimulated and EMG is measured.This conduction velocity
measurement is used to indicate the location and type of nerve lesion.
Steps involved in measurement of conduction velocity
• Stimulte is applied at point A

• Electrical activity of muscle is measured at point B
• The space between A and B is noted as l1 meters.
• The time delay between applying stimulus and receiving action potential is known as
latency. This time delay is detoned as t1 second.
• Now change the position of A into C. Now the space is reduced. It is noted as l2 meters.
• The time delay noted is t2 second.
• Usually, l2<l1 and t2 <t1.
• Now , the conduction velocity is given as , V= l1-l2/t1-t2.
• Usually V= 50 m/sec.
• If V<40 m/s. It means there is some disorder in nerve conduction.
• Thus conduction velocity is measured in motor nerves.
• Skeletal muscle is organized functionally on the basis of the motor unit.
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Figure 1.30 Conduction Velocity In Motor Nerves
Single Motor Unit (SMU)
• The motor unit is the smallest unit that can be activated by a volitional effort (all
constituent muscle fibers are activated synchronously)
• Single motor unit (SMU) consists of a single motor neuron and the group of skeletal
muscles that it innervates
• SMU is a distributed unit bioelectric source in a volume conductor consisting of all other
muscle fibers, both active and inactive.
• The evoked extracellular field potential from the active fibers of an SMU has a triphasic
form of 3-15 ms duration and 20-2000 μV amplitude depending on the size of SMU
• The figure below shows motor unit potentials from normal muscle under graded levels of
contraction. At high levels of activity, many sophisticated motor unit responses give rise
to a complicated response (interference pattern)
Figure 1.31 EMG Recording

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• A variety of electrodes have been developed for EMG recording

• The figure below shows the needle and wire electrodes used in recording the EMG signal
• The EMG is also of considerable clinical value
• The shape of SMU potentials is modified by disease
The figure below shows the EMG response for a normal subject and one with neuropathy
Figure 1.32 EMG response of a normal and an abnormal waveforms
Applications of EMG:
EMG is used in the field of:

• Electrophysiological testing.
• Clinical neurophysiology.
• Neurology.
• Psychiatry.
1.7 EOG (ELECTROCULOGRAM)
EOG is the recording of the biopotentials generated by the movement of eyes. Here,
corneal-retinal potentials associated with eye movement is recorded. Electrode used in EOG:
surface electrodes are used to measure EOG.
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Figure 1.33 EOG Waveforms
Figure 1.34 Recording of Electroculogram
EOG MEASUREMENT
 Block diagram of EOG measurement system is shown. In the figure, position of

electrodes is shown.
 One pair of electrodes is placed above and below the nose. These electrodes are
used to measure the vertical movement of eye. The signals from these two pairs of
electrodes are given to the amplifier.
 Another pair of electrodes is placed in the left side and right side of the eye.
Horizontal movement of an eye is measured by using these electrodes.
 The signals from these electrodes are given to the amplifier circuit.
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Applications of EOG
 The effect of some drugs on the eye movement systems can be identified by
using EOG.
 It is used to analyze the state of semicircular canals.
 Diagnosis of the neurologic disorders is possible.
 The level of anesthesia can be indicated by the characteristic of eye
movement
1.8 PCG (PHONO CARDIOGRAM)
The graphical record of heart sound is known as Phono Cardiogram. Here Cardio
means the heart. The device which is used to measure heart sound is known as phonocardiograph.
Auscultation: The technique of listening sound produced by organs and vessels of the body is
known as auscultation.
In PCG, different types of heart sounds are measured. These heart sounds are due to the
vibrations set up in the blood inside the heart by the sudden closure of valves. In abnormal heart
additional sounds are heard between the normal heart sound. These additional sounds are known
as murmurs.Murmers is generally caused by improper opening of the valves or by regurgitation.
CLASSIFICATION OF HEART SOUND
It is divided into four types
 Valve closure sound

 Ventricular filling sound
 Valve opening sound
 Extra cardiac sound
Valve closure sound
This sound occurs at the beginning of systole and at the beginning of diastole.
Ventricular filling sound
This sound is occurred at the time of filling of the ventricles.
Valve opening sound
This sound occurs at the time of opening of atrioventricular valves and semi lunar
valves.
Extra cardiac sound
This sound occur in mid systole or late systole or early diastole
Systole: The contraction of the heart muscle. The systolic pressure is 120mm of Hg.
Diastole: The relaxation of the heart muscle. The diastolic pressure is 80 mm of Hg.
1.8.1 PCG RECORDING SYSTEM
Microphone is used to convert heart sound into the electrical signals. Certain positions are
recommended to pick up the heart sound by using microphone. The electrical signal picked up by
the microphone is amplified by the amplifier block. The amplified output is given to filter block.
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Condenser Output unit

Amplifier Filter
microphone
FM tape
ECG ECG recorder
electrode amplifier
Figure 1.35 Block Diagram of PCG Recording System
Figure 1.36 Characteristics and Filter circuit
Here high pass filter is used. Its cut of frequency is 1 kHz. Here ECG electrode system
and ECG amplifiers are usedfor reference for PCG. So ECG and PCG outputs are connected to
FM tape recorder and output display unit.
TYPES OF MICROPHONES USED IN PCG
1. Air coupled microphone- Movement of chest is transferred through the air cushion. It
provides low mechanical impedance to the chest.
2. Contact microphone – it is directly coupled to the chest wall and provides high
impedance, high sensitivity, and low noise. Its light weight is also one of the
advantageous factor.
The first heart sound is developed during the opening of aortic valve and during the closing of
mitral valve
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PCG waveform
Frequency of first heart sound consists of 30 to 45 Hz. Second heart sound is usually
higher in pitch than the first. Its frequency range is 50Hz to 70 Hz. Third heart sound is extremely
weak vibrate sound is extremely weak vibration. Its frequency is below 600 Hz.
Aortic stenos are murmur occurred when the blood is ejected from the left ventricle
through aortic valve due to resistance to ejection, the pressure in the left ventricle increased. So
turbulent blood flow occur.This turbulent blood impinging the aortic valve. So intense vibration
is produced. It produces loud murmur.
Mitral regurgitation murmur- In this murmur, blood flows in backward direction through the
mitral valve during systole.
Aortic regurgitation murmur – During diastole, sound is heard. In diastole blood flows in the
backward direction from aorta to left ventricles when valves are damaged, then this sound is
heard.
Mitral stenosis murmur – This murmur is produced when blood is passed from left atrium to
left ventricle. This sound is very weak.
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UNIT III
BIO AMPLIFIER
Need for bio-amplifier - single ended bio-amplifier, differential bio-amplifier – right leg driven
ECG amplifier. Band pass filtering, isolation amplifiers – transformer and optical isolation -
isolated DC amplifier and AC carrier amplifier. Chopper amplifier, Power line interference
Chopper Amplifier:
The chopper is used to convert low frequency signal into a high frequency signal. The
modulated high frequency signal is amplified and finally the amplified signal is
demodulated and filtered to get low frequency signal. Chopper amplifier has no drift.
Chopper amplifiers are available in the form in the form of mechanical and non-
mechanical chopper.
i) Mechanical Chopper Amplifier:
Fig 1.10: Chopper amplifier using a mechanical switch
Chopper S1 is an electromagnetically operated switch or relay. S1 connect the input

terminal of amplifier ‗A‘to reference terminal ‗Q‘which is connected to ground. When
the amplifier input terminal is connected with Q, it is short circuited and the input
voltage is zero. When S1 is open, the amplifier receives the signal voltage from P.
ii) Non mechanical Chopper Amplifier:
iii)
Fig 1.11: Non Mechanical Photoconductive Chopper Amplifier
Photoconductors or photodiodes are used as non mechanical chopper for modulation

and demodulation. When there is no incident light on photoconductor, its resistance is
high and hence it is in RB and no current flows through it. When there is incident light
on photoconductor, its resistance is very low and hence it is in FB and current flows
through it. Thus it can act as a switch by means of incident light.
Cardiac Output Measurement
UNIT IV
MEASUREMENT OF NON-ELECTRICAL PARAMETERS
Temperature, respiration rate and pulse rate measurements. Blood Pressure: indirect methods - auscultatory
method, oscillometric method, direct methods: electronic manometer, Pressure amplifiers - systolic, diastolic,
mean detector circuit. Blood flow and cardiac output measurement: Indicator dilution, thermal dilution and dye
dilution method, Electromagnetic and ultrasound blood flow measurement.
Figure 2.22 Cardiac output measurement
2.11 RESPIRATORY RATE MEASUREMENT
Respiratory system provides a means of acquiring oxygen and eliminating CO 2. Various

laws are involved in the understanding of respiratory functions.
Various Gas laws are given below:
1. BOYLE’S LAW: It states that at constant temperature, the volume of gas varies
inversely with the pressure.
V2/V1 =P1/P2 here temperature T= constant
V2= Final volume
V1 = Initial volume
P1 = Original (initial) pressure
P2 = Final pressure
2. CHARLE’S LAW: It states that, at constant pressure, the volume of gas isdirectly
proportional to the absolute temperature.
V2/V1 =T2/T1 Here pressure P=constant
V2, V1 =Final, initial volume
T1 =original temperature
T2 = Final temperature
3 . HENRY’S LAW : It states that, if the temperature is constant, the quantity of a gas that
goes into a solution is directly proportional to the partial pressure of that gas . The gas with the
greater partial pressure will have more mass in solution.
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4. DALTON’S LAW : It states that, the total pressure exerted by a mixture of gases is equal to
the sum of the partial pressures of various gases.
PT =P1 + P2 + …………… +Pn
PT = total pressure
P1, P2 ,P3 = partial pressure of various gases
TYPES OF RESPIRATION
Types of respiration
Internal respiration External respiration
Respiration is nothing but the interchange of gases between an organism and the living medium
Internal respiration is the exchange of gases between the blood stream and nearby cells
.External respiration is the exchange of gases between the lungs and blood stream .
Lungs Volumes and Capacities (Respiration Parameters) Or (LVC)
Respiration parameters are used to indicate the state of respiratory function , including lung
volumes and capacities , airway resistance , lung compliance , etc .
Dead Air
Only a portion of the air entering the respiratory system actually reaches the alveoli . The
volume of air that is not available for gas exchange with the blood is known as dead air . The
total dead space is less less than 30 percentage of the total volume .
Tidal Volume (TV)
Tidal volume is the depth of breathing or the volume of gas inspired or expired during each
respiratory cycle. It is equal to 500 ml for a normal person .
Inspiratory Reserve Volume (IRV)
It is the maximal amount of gas that can be inspired from the end- inspiratory position (
Extra inspiration from the high peak tidal volume . It is equal to 3600 ml for a normal person
Expiratory reserve volume (ERV)
It is the maximal amount of gas that can be end expiratory level. It is equal to 1200 ml.
Residual Volume(RV)
It is the amount of gas remaining in the lungs at the end of maximal expiration. It is equal
to 1200 ml.
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Minute Volume (MV)

It is the volume of air breathed normally for 1 minute.
Total Lung Capacity(TLC)
It is the amount of gas contained in the lungs at the end of maximal inspiration and it is
the sum of inspiratory capacity(IC) and functional residual capacity (FRC). TLC is of 6000 ml
for a normal person.
Vital Capacity(VC)
It is the maximum amount of gas that can be expelled from the lungs by forceful effort
from maximal inspiration. It is 4800 ml for a normal person.
Inspiratory Capacity(IC)
It is the maximum amount of gas that can be inspired from the resting expiratory level and
it is the sum of tidal volume and inspiratory reserve volume. It is equal to 3600 ml for a normal
person.
Functional Residual Capacity(FRC)
It is the amount of gas remaining in the lungs at the resting expiratory level.
FRC = ERV + RV
Airway resistance
It relates to the ease with air flows through tubular respiratory structures. In smaller tubes,
airway resistance is high.
Lung Compliance
It is the ability of the alveoli and lung tissue to expand on inspiration.
Lung Elasticity
It is the ability of the lung’s elastic tissues to recoil during expiration
Intra thoractic Pressure
It is the positive and negative pressure occur within the thoracic cavity
Types of respiration rate measurement
1. Displacement method
2. Thermistor method
3. Impedance pneumography
4. CO2 method
5. Apnoea detectors
Displacement Method
In this method the transducer is hold by an elastic band which goes around the chest.The
respiratory movements results in a corresponding resistance changes of the strain gauge. It is
connected as one arm of a wheatstone bridge circuit. Its output varies with chest expansion. This
output corresponds to the respiration activity.
Thermistor Method
Generally there is a temperature difference between inspired and expired air. This temperature is
sensed by placing thermistor in front of nostrils. Thermistor is placed by using suitable stand. The
thermistor is connected with the bridge circuit. So unbalance signal is amplified to get the
respiratory activity.
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2.11. 1 IMPEDANCE PNEUMOGRAPHY
This is the indirect method of measurement . impedance pneumography is based on the fact
that , the a.c impedance across the chest of a patient changes as respiration occurs . 50-50KHz a.c
signal is produced by oscillator circuit and is given to the chest of the patient through electrodes
.The signal voltage applied to the amplifier (Differential amplifier) block is the voltage drop
across the resistance .
50 to 500
kHz
oscillator
patient
Amplifier Demodulator recorder
Figure 2.23 Impedance pneumography
V = I(R+ R)
Where V= Output voltage (V)
I= Current through the chest (A)
R= chest impedance without respiration (R)
R= change of chest impedance due to respiration (Q)
The output of the amplifier is given to demodulator and filter block. Hence low pass filter is used
to remove the residual carrier signal. The output of the impedance pneumograph contains
respirating rate data.
CO2 Method
Respiration rate can be measured by measuring CO2 in expired air. This CO2 method of
measurement is based on the absorption property of infrared rays by certain gases .When infrared
rays are passed through the expired air which contains certain amount of CO2, some of radiations
are absorbed by it. So, there is loss of heat energy associated with the rays .The detector changes
the loss in heating effect of the rays into an electrical signal. It is used to get the average
respiration rate. Two infrared sources are available in this set up. The beam from one infrared
source falls on the test cuvette side. The beam from another infrared source falls on the reference
cuvette side.
The detector has two identical portions. These portions are separated by a thin, flexible
metal diaphragm. The detector is filled with a sample of pure CO 2. Because of the absorption of
CO2 in the test cuvette. The beam falling on the test side of the detector is weaker that falling on
the reference side. The gas in reference side is heated more than that on the test side. So
diaphragm is pushed slightly to the test side of the detector. This diaphragm forms one plate f a
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capacitor. The a.c signal appears across the detector is amplified and recorded using recorder.
The amplified output is integrated. It is used for continuous monitoring the respiration rate.
Apnoea Detectors
Apnoea is the stopping of breathing. It leads to the arrest of the circulation. It can be
occurred at the conditions like head injury, drug overdose, etc. It can also occur in premature
babies during the first week of life because of their immature nervous system. If apnoea persists
for a prolonged period, then brain functions can be severly damaged. So apnoea patients are
closely monitored. Apnoea monitor is used to watch the apnoea patients respiration rate. Apnoea
monitor gives audio signals and visual signals, when no inspiration occurs for a particular period
of time. Input from the sensor is connected with the amplifier circuit having high input
impedance.
Negative Positive Comparator Lamp to show

detector detector circuit motion
Sensor Lamp to
signal from amplifier indicate
the patient respiration
LPF Schmitt Alarm

circuit circuit
Apnoea period
selector circuit
Figure 2.24 Block diagram of apnoea monitor

The output of the amplifier circuit is connected with motion and respiration channel
blocks. Motion channel block differentiates motion and the respiration based on the frequency.
The frequency below 1.5 Hz is identified as respiration. The frequency above 1.5 Hz is identified
as motion. High frequency signal above the threshold is sensed by positive detector.
The frequency below the threshold is sensed by negative detector. The output of the
motion channel is connected with comparator circuit. It compares the amplitude of motion and
respiration. Based on the output corresponding lamp will glow. In the respiration channel, low
pass filter is used to remove high frequency signal. If there is no respiration, then schmid trigger
circuit gives the output to switch on the alarm.
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Apnoea period selector circuits contain low frequency alarm oscillator and tone oscillator,
and audio amplifier. Apnoea period selector circuit drives the alarm circuit. The output of alarm
circuit is connected with the speaker. So, where there is no respiration for a period of 10 or 20
sec, then audio signal through the speaker and visual signal through the flash light is delivered.
2.12 BLOOD PRESSURE
One of the oldest physiological measurements.Observation of blood pressure allows

dynamic tracking of pathology and physiology affecting to the cardiovascular system, which has
profound effects to all other organs of the body
Figure 2.25 Observation of blood pressure
• Originates from the heart

• Commonly refers to arterial blood pressure
Value depends on 3 factors:
• cardiac output diameter of arteries the quantity of blood

• Values should be lower than 120 / 80 mmHg(systolic pressure (SP) / diastolic pressure
(DP))
• High value increases the risk of heart attack and strokes
• Low value increases the risk of lower oxygen perfusion e.g. in brains.
However, the ’normal values’ differ from person to another
Pulse Pressure(PP) = SP - DP
Mean pressure (MP)

Average pressure during one cardiac cycle driving force of the peripheral perfusion.
an estimate can be done by using an empirical formula:
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MP = DP+PP/3
SP and DP may vary significantly throughout the arterial system but MP is quite uniform (in
normal situations)
1. Non-Invasive
Palpatory Method(Riva-Rocci Method)
Auscultatory Method
Ultrasonic Method
Oscillometric Method
Tonometry
2. Invasive
Extravascular Sensor
Intravascular Sensor
General on System Parameters
2.12.1 INDIRECT METHODS IN BLOOD PRESSURE MEASUREMENTS
Indirect measurement = non-invasive measurement
Figure 2.26 Blood pressure measurements

Brachial artery is the most common measurement site
Close to heart
Convenient measurement
Other sites are e.g.:
forearm / radial artery wrist (tends to give much higher SP)
The most common indirect methods are auscultation and oscillometry an occlusive cuff is
placed on arm and inflated to P > SP. Then the cuff is deflated gradually and the measurement of
blood flow is done .
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The occlusive cuff should be of a correct size in order to transmit the pressure to the
artery evenly and thus to obtain accurate results .A short cuff requires special attention in
placement. Longercuff reduces this problem. The cuff should be placed at the heart level in order
to minimize the hydrostatic effects .
Figure 2.27 Sphygmomanometro
2.12.1.1 PALPATORY METHOD (RIVA-ROCCI METHOD)
When the cuff is deflated, there is a palpable pulse in the wrist. P = BP .Several
measurements should be done as the respiration and vasomotor waves modulate the blood
pressure levels
Figure 2.28 Palpatory Method
Advantages
The blood pressure can be measured in noisy environment too
Technique does not require much equipment
Disadvantages
Only the systolic pressure can be measured (not DP)
The technique does not give accurate results for infants and hypotensive patients
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2.12.1.2 AUSCULTATORY METHOD

Pulse waves that propagate through the brachial artery, generate Korotkoff sounds. There
are 5 distinct phases in the Korotkoff sounds, which define SP and DP The Korotkoff sounds are
ausculted with a stethoscope or microphone (automatic measurement
Figure 2.29 Auscultatory Method

The frequency range is 20-300 Hz and the accuracy is +/- 2mmHg (SP) and +/- 4mmHg (DP).
Also with this method, several measurements should be done.
Advantages
Auscultatory technique is simple and does not require much equipment
Disadvantages
Auscultatory tecnique cannot be used in noisy environment
The observations differ from observer to another
A mechanical error might be introduced into the system e.g. mercury leakage, air leakage,
obstruction in the cuff etc.
The observations do not always correspond with intra-arterial pressure
The technique does not give accurate results for infants and hypotensive patients
2.12.1.3 ULTRASONIC METHOD
A transcutaneous (through the skin) Doppler sensor is applied here. The motion of blood-
vessel walls in various states of occlusion is measured. The vessel opens and closes with each
heartbeat when DP < P < SP .
The frequency difference between transmitted (8 MHz) and received signal is 40-500 Hz
and it is proportional to velocities of the wall motion and the blood. As the cuff pressure is
increased, the time between opening and closing decreases until they coincide.
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Figure 2.30 Ultrasonic Method
Advantages & Disadvantages

Can be also used in noisy environment
Can be used with infants and hypotensive individuals
Subject’s movements change the path from sensor to vessel
2.12.1.4 OSCILLOMETRIC METHOD
The intra-arterial pulsation is transmitted via cuff to transducer (e.g. piezo-electric) .The
cuff pressure is deflated either linearly or stepwise.The arterial pressure oscillations (which can
be detected throughout the measurement i.e. when P > SP and P < DP) are superimposed on the
cuff pressure SP and DP are estimated from the amplitudes of the oscillation by using a
(proprietary) empirical algorithm.
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Figure 2.31 Oscillometric Method
Advantages
In the recent years, oscillometric methods have become popular for their simplicity of use
and reliability.
MP can be measured reliably even in the case of hypotension
Disadvantage
Many devices use fixed algorithms leading to large variance in blood pressures
2.12.1.5 TONOMETRY
Linear array of pressure sensors is pressed against a superficial artery, which is supported
from below by a bone (radial artery). A sensor array is used here, because at least one of the
pressure sensors must lay directly above the artery .When the blood vessel is partly collapsed, the
surrounding pressure equals the artery pressure
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Figure 2.32 Tonometry
The pressure is increased continuously and the measurements are made when the artery is
half collapsed. The hold-down pressure varies between individuals and therefore a ’calibration’
must be done
Advantages
Can be used for non-invasive, non-painful, continuous measurement
Disadvantages
Relatively high cost
The wrist movement and tendons result in measurement inaccuracies
2.12.2 DIRECT METHODS IN BLOOD PRESSURE MEASUREMENTS
Direct measurement = Invasive measurement
A vessel is punctured and a catheter (a flexible tube) is guided in The most common sites
are brachial and radial arteries but also other sites can be used e.g. femoral artery A division is
made into extravascular and intravascular sensor systems .This method is precise but it is also a
complex procedure involving many risks Used only when essential to determine the blood
pressure continuously and accurately in dynamic circumstances
2.12.2.1 EXTRAVASCULAR SENSOR

The sensor is located behind the catheter and the vascular pressure is transmitted via this
liquid-filled catheter.
The actual pressure sensor can be e.g. strain gage,variable inductance,variable capacitance
Optoelectronic,piezoelectric, etc…
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Figure 2.32 Extravascular Sensor

The hydraylic link is the major source of errors. The system’s natural frequency may be damped
and degraded due (e.g.):
too narrow catheter
too long tubing
various narrow connections
air bubbles in the catheter
Figure 2.33 Catheter sensor system
The catheter-sensor system must be flushed with saline-heparine solution every few minutes in
order to prevent blood from clotting at the tip.
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Normally the interesting frequency range is 0 – 100 Hz. If only MP is measured the
bandwidth is 20 Hz (harmonics > 10 are ignored)
2.12.2. 2 INTRAVASCULAR SENSOR

sensor is located in the tip of the catheter. This way the hydraulic connection is replaced
with an electrical or optical connection .The dispacement of the diaphragm is measured .The
frequency response is not limited by the hydraulic properties of the system.
No time delay.
Electrical safety and isolation when using fiber optics
Breaks easily
More expensive
Disposable Sensors
Disposable sensors decrease the risk of patient cross-contamination and reduce the
amount of handling by hospital personnel
Cheaper and more reliable than reusable pressure sensors
2.12.2.3 GENERAL ON SYSTEM PARAMETERS
Even minute air bubbles in catheter have a dramatic effect on frequency response
The natural frequency and the length of the catheter have a following relationship:
fn = 1
L
The catheter diameter has a linear relationship to natural frequency Stiffer catheters have
a higher frequency response
2.13 TEMPERATURE MEASUREMENT:

Temperature is one of the inductor of the general well being. Two types of temperature
measurements can be obtained from the body. These are
• Systematic temperature
• Surface temperature
Systematic temperature is the temperature of the internal region of the body. Usually, the
heat is generated by the active tissues of the body and heat is lost by the body to the environment.
But, the temperature of the body is maintained carefully. The normal mouth temperature is 37 0C.
the normal underarm temperature is about 10C lower than the above temperature. Systemic
temperature is measured accurately at tympanic membrane of ear. The brain contains the
temperature control centre for the body.
Systemic body temperature measurement
Mercury thermometer is used to measure the systemic temperature. It is inexpensive to use..

when continuous temperature recording is necessary, then, thermocouple or thermistor can be
used. In thermocouple, a junction of two dissimilar metals produces an output voltage. This is
proportional to the temperature at that junction.
Thermistor is a temperature sensing device. Its resistance varies with the temperature. This is
mostly preferred in the biomedical field compared with thermocouple. Thermistor can be
manufactured in a various shapes. In this thermistor, the relationship between resistance change
and temperature is nonlinear. The resistance of the thermistor is given by using the expression,
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Rt = Rr eβ(1/T1 - 1/T0)
Rt =resistance at temperature Tt
Rr = resistance at temperature T0
T1 = temperature at which measurement is taken
T0 = reference temperature
Β = temperature cosfficient
Special circuits are used to overcome the nonlinear characteristics of thermistors. This
special circuit consists of 2 matched thermistors.
Problems associated with thermistor
Self heating is very important problem in thermistor. This problem can be overcome by
limiting the current used in measurement. The power dissipation of thermistor is to be
maintained in milliwatts range to overcome this problem.
Thermistor probe should be chosen correctly based on

• Resistance range
• Sensitivity
Skin temperature measurement
Skin temperature is not constant throughout the body. It is varied from 300C to 350C. Various
factors affect the skin temperature are given below
• How fat covers over capillary area
• How the skin portion is exposed to ambient temperature
• Blood circulation pattern beneath the skin
Probe used for measurement
A small flat thermistor probe is used to measure the skin temperature.
Infrared thermometer
It is a device used to measure skin surface temperature. It is used to locate breast cancer. It is
also used to identify the spots in which blood circulation is poor.
2.14 PULSE MEASUREMENT
When heart muscle contracts , blood is ejected from the ventricles and a pulse of pressure is
transmitted through the circulatory system. This pulse can be measured at various points. We can
sense the pulse by placing our finger tip over the radial artery in the wrist. This pulse travels at
the speed of 5 to 15m per second. Photoelectric method is commonly employed to measure the
pulse.
Types:
Photoelectric method consists of two types
• Tramsmittance method
• Reflectance method
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2.14.1 TRANSMITTANCE METHOD OF PULSE MEASUREMENT
LED and photoresistor are used in this method. These are mounted in a enclosure that fits
over the tip of the finger. Light is produced by the LED. The same light is passed through the
finger. For each heart pulse , blood is forced to the extremities and the amount of blood in the
finger is increased. So optical density is changed. So, the light transmitted through the finger is
decreased. This light is received by the photo resistor. This photo resistor is connecte with the
part of voltage divider circuit. The voltage produced by this circuit is directly proportional to the
amount of blood flow in the figure. The output ius recorded by using strip chart recorder.
2.14.2 Figuer 2.34 Transmittance Method Of Pulse Measurement
2.14. 2 REFLECTANCE METHOD
N reflectance method, LED is placed adjacent to the photoresistor. LED emits the light.
This light is reflected form the skin and the tissues falls on the photo resistor. The reflected light
varies depending upon the blood flow in the finger. The photo resistor is connected as a part of
the voltage divider circuit. The output obtained is directly proportional to the amount of blood in
the finger. The output can be recorder using strip chart recorder.
Figure 2.35 Reflectance Method

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BLOOD FLOWMETER
Blood flow meters are used to monitor the blood flow in various blood vessels and
to measure cardiac output.
Blood flow is the continuous circulation of blood in the cardiovascular system.
The science dedicated to describe the physics of blood flow is called hemodynamics.
Usually the blood flow measurements are more invasive than blood pressure
measurements / ECG
The abnormal changes in the blood flow or blood velocity gives rise to malformation
of vessels.
Blood flow is nothing but the volume of blood per time [ml/min].
Typical values for blood flow [cm/s]:

1. Aorta 100 – 250
2. Abdominal 100
3. Vena Cava 5 – 40
Types
· Electromagnetic blood flow meters
· Ultrasonic blood flow meters
· Laser based blood flow meters
2.9.1 ELECTROMAGNETIC FLOWMETERS

 Electromagnetic blood flow meters measure blood flow in blood vessels
 Consists of a probe connected to a flow sensor box
Figure 2.12 Blod flow meter
An Electromagnetic Flow Meter is a device capable of measuring the mass flow of a

fluid. Unlike the common flow meter you can find on the market it has no moving
parts, and for this reason it can be made to withstand any pressure (without
leakage)and any fluid(corrosive and non corrosive). This kind of flow meter use a
magnet and two electrodes to peek the voltage that appears across the fluid moving in
the magnetic field.
Figure 2.13 Electromagnetic Flowmeter
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The Neumann Law (or Lenz Law) states that if a conductive wire is
moving at right angle through a magnetic field, a voltage E [Volts] will appear
at the end of the conductor (Fig.1):
E=B*L*V
Where
B = Magnetic Induction
[Weber/m2]
L = Length of the portion of the wire 'wetted' by the
magnetic field [m]
V = Velocity of the wire [m/sec]
Figure 2.14 Magnetic Blood flowmeter priciple
Now imagine you have a plastic tube with two electrodes on the diameter and
Mercury flowing into it (fig.2). A voltage will appear on the electrodes and it will be
E=B*L*V
As in the previous example (L in this case is the inner diameter of the tube).Mercury as
tiny conductive wires next to each other: each wire, moving in the tube, will touch the two
electrodes ,and thus you can measure their voltage.
An interesting fact is that if you reverse the flow, you still get a voltage but with
reverse polarity (Fig.1). Till now we have talked about a conductive fluid ,Mercury, but
this stuff will also work with non conductive fluid, provided that you use an alternating
magnetic field. Two physicists, Middleman and Cushing, in an unpublished work, stated that
when using a non conductive fluid, if the frequency of the alternating magnetic field is v the
voltage at the electrodes will be attenuated by a factor a so that:
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Measuring the flow
`A perfect axisimmetric construction cannot be achieved and thus some

magnetic flux lines will 'wet' the connecting wires to the electrodes. The alternating
magnetic field will create an offset voltage in this wire and even if the fluid is not
moving, the measured voltage will not be zero.
2.9.2 ULTRASONIC FLOWMETERS
The blood cells in the fluid scatter the Doppler signal diffusively.In the recent years
ultrasound contrast agents have been used in order to increase the echoes.The ultrasound beam is
focused by a suitable transducer geometry and a lens.
Figure 2.15 Ultrasonic flowmeters
fd = 2fcv/c
f = 2- 10 MHz
c = 1500 - 1600 m/s (1540 m/s)
f = 1,3 – 13 kHz
In order to know where along the beam the blood flow data is colledted, a pulsed Doppler
must be used.The flow velocity is obtained from the spectral estimation of the received Doppler
signalThe ultrasound Doppler device can be either a continuous wave or a pulsed Doppler
A Continuous Wave
No minimum range
Simpler hardware
Range ambiguity
Low flow cannot be detected
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A Pulsed Doppler
Accuracy
No minimum flow
Minimum range
(Maximum flow) x (range)= limited the power decays exponentially because of the heating
of the tissue. The absorption coefficient ~ proportional to frequency the far field operation should
be avoided due to beam divergence.
Dnf = D2/ 4
D = Transducer diameter (e.g. 1 – 5 mm) the backscattered power is

proportional to f .The resolution and SNR are related to the pulse duration. Improving
either one of the parameters always affects inversely to the other
2.9.3 LASER DOPPLER FLOWMETRY
The principle of measurement is the same as with ultrasound

Doppler.The laser parameter may have the following properties:5 mWHe-Ne-laser
632,8 nm wavelength.
Figure 2.16 Laser Doppler flowmeter
The moving red blood cells cause Doppler frequency 30 – 12 000 Hz.The
method is used for capillary (microvascular) blood flow measurements
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Indicator Dilution Methods
Dye Dilution Method
A bolus of indicator, a colored dye (indocyanine green), is rapidly injected in to

the vessel. The concentration is measured in the downstream The blood is drawn
through a colorimetric cuvette and the concentration is measured using the principle of
absorption photometry
Figure 2.17 Dye Dilution Method
Thermal Dilution Method
A bolus of chilled saline solution is injected into the blood circulation system (right
atrium). This causes decrease in the pulmonary artery temperature. An artery puncture
is not needed in this technique.Several measurements can be done in relatively short
time .A standard technique for measuring cardiac output in critically ill patients
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Photoelectric Method
A beam of IR-light is directed to the part of the tissue which is to be measured for blood
flow (e.g. a finger or ear lobe)
Figure 2.18 Photoelectric Method
The blood flow modulates the attenuated / reflected light which is recorded.The light that
is transmitted / reflected is collected with a photodetector
Radioisotopes
A rapidly diffusing, inert radioisotope of lipid-soluble gas ( Xe or Kr) is injected into

the tissue or passively diffused
Figure 2.19 Radioisotopes
The elimination of the radioisotope from microcirculatory bed is related to the blood flow:
Thermal Convection Probe
• This is one of the earliest techniques for blood flow measurements

• The rate of heat removal from the tissue under probe is measured
• The concentric rings are isolated thermally & electrically from each other
SCE 49 DEPT.OF ECE
The central disk is heated 1 – 2 C over the temperature of tissue.A temperature difference of
2- 3 C is established between the disks.The method is not very common due extreme nonlinear
properties and difficulties in practical use (e.g. variable thermal characteristics of skin)
Figure 2.20 Thermal Convection Probe
2.10 CARDIAC OUTPUT
Definition: Volume of blood pumped by the heart per min

CO = SV x HR
Norm ~ 5 l/min
Cardiac index – corrected for body surface area
Affected by :
Met. Rate – pregnancy, hyperthyroid, septic
Preload / contractility / afterload
Clinical indicators of CO imprecise
Affected by anaesthetic agents used in everyday practice
Provides estimate of:
• whole body perfusion
• oxygen delivery
• left ventricular function
Persistently low CO associated with poor outcome
SCE 50 DEPT.OF ECE
Methods: Fick method

Dilution techniques – dye / thermal / lithium
Pulse contour analysis- LiDCO & PiCCO
Oesophageal doppler
TOE
Transthoracic impedance plethysmography
Inert gas through flow
Non-invasive cardiac output measurement
Fick Principle: Measure volume displacement 1st proposed 1870 ―the total uptake or release
of a substance by an organ is the product of the blood flow through that organ and the
arteriovenous concentration difference of the substance. Limited by cumbersome equipment,
sampling errors need for invasive monitoring and steady-state haemodynamic and metabolic
conditions
Indicator dilution techniques
An indicator mixed into a unit volume of constantly flowing blood can be used to
identify that volume of blood in time, provided the indicator remains in the system
between injection and measurement and mixes completely in the blood.
Dye dilution
• Inert dye – indocyanin green

• Injected into pulmonary artery and arterial conc. measured
using a calibrated cuvette densitometer
• Plot indicator dilution curve (see diagram) CO derived from area under
curve.
Indicator Dilution Curve
Figure 2.21 Indicator dilution curve
SCE 51 DEPT.OF ECE

Cardiac Output Measurement
Figure 2.22 Cardiac output measurement
2.11 RESPIRATORY RATE MEASUREMENT
Respiratory system provides a means of acquiring oxygen and eliminating CO 2. Various

laws are involved in the understanding of respiratory functions.
Various Gas laws are given below:
1. BOYLE’S LAW: It states that at constant temperature, the volume of gas varies
inversely with the pressure.
V2/V1 =P1/P2 here temperature T= constant
V2= Final volume
V1 = Initial volume
P1 = Original (initial) pressure
P2 = Final pressure
2. CHARLE’S LAW: It states that, at constant pressure, the volume of gas isdirectly
proportional to the absolute temperature.
V2/V1 =T2/T1 Here pressure P=constant
V2, V1 =Final, initial volume
T1 =original temperature
T2 = Final temperature
3 . HENRY’S LAW : It states that, if the temperature is constant, the quantity of a gas that
goes into a solution is directly proportional to the partial pressure of that gas . The gas with the
greater partial pressure will have more mass in solution.
SCE 52 DEPT.OF ECE
UNIT V
BIO-CHEMICAL MEASUREMENT
Biochemical sensors - pH, pO2 and pCO2, Ion selective Field effect
Transistor (ISFET), immunologically sensitive FET (IMFET), Blood glucose
sensors - Blood gas analyzers, colorimeter, flame photometer,
spectrophotometer, blood cell counter, auto analyzer (simplified schematic
description).
Blood pH Measurement
 In chemistry, pH is the negative log of the activity of the hydrogen ion in an
aqueous solution.
 Solutions with a pH less than 7 are said to be acidic and solutions with a pH
greater than 7 are basic or alkaline.
 Pure water has a pH of 7.
 Mathematically, pH is the negative logarithm of the activity of the (solvated)
hydronium ion, more often expressed as the measure of the hydronium ion
concentration
 Blood pH is an important factor to determine the acid base balance in the
human body.
 Blood pH level plays an important role for your overall health, because if your
blood pH level is acidic, your cells cannot function properly.
 One of the major contributors to acidosis is carbon dioxide, a byproduct of
metabolism.
 Carbon dioxide combines with water to form carbonic acid. The normal pH
of blood is between 7.35-7.45.
 The increase in hydrogen ion concentration causes the pH of the body fluids
to decrease.
 If the pH of the body fluids falls below 7.35, symptoms of respiratory acidosis
become apparent.
 Blood gas analyzers are used to measure pH, pCO2 and pO2 etc
 pH of biological fluids is measured using a glass electrode.
UNIT II
BIO-CHEMICAL AND NON ELECTRICAL PARAMETER MEASUREMENT
2.1 PH MEASUREMENT
The chemical balance in the body can be determined by the ph value of blood and other
body fluids.ph is defined as the hydrogen ion concentration of a fluid. It is the logarithm of the
reciprocal value of h+ concentration. The ph equation is given as,
Ph= - log10 [H+] = log10 1/[H+ ]
pH is the measure of acid- base balance in a fluid, A neutral solution has the ph value as 7.
Solutions with pH value less than 7 are acidic and above 7 are basic. Most of the body fluids are
slightly basic in nature.
Construction and working
The ph meter is made up of a thin glass membrane and it allows only the hydrogen ions
to pass through it. The glass electrode provides a membrane interface for H+ ions. The glass bulb
at the lower end of the ph meter contains a highly acidic buffer solution. The glass tube consists
of a sliver-sliver chloride (Ag/Agcl) electrode and the reference electrode which is made up of
calomel sliver-sliver chloride(Ag/Agcl) is tan placed in the solution in which ph is being
measured.
The potential is measured across the two electrodes. The electrochemical measurement,
which should be obtained by each of the electrodes called half- cell. The electrode potential is
called as half-cell potential. Here the glass electrode inside the tube constitutes one half –cell and
the calomel or reference electrode is considered as the other half-cell.
Figure 2.1 pH Electrode
SCE 34 DEPT.OF ECE

For easier ph measurement combination electrodes are used. In this type both the active
glass electrode and reference electrode are present in the same meter. The glass electrodes are
suitable only to measure ph values around 7. Since this type of glass electrodes produce
considerable errors during the measurement of high Ph values, special type of Ph electrodes are
used. After every measurement the pH meter is washed with 20% ammonium biflouride solution,
for accurate results. The Ph meter with hydroscopic glass absorbs water readily and provides best
pH value.
2.2 pO2 MEASUREMENT
The term po2 is defined as the partial pressure of oxygen respectively. The determination
of po2 is one the most important physiological chemical measurement. The effective functioning
of both respiratory and cardiovascular system can be by po2 measurement. The partial pressure of
a gas is proportional to the quantity of that gas present in the blood.
The platinum wire, which is an active electrode, is embedded in glass for insulation and
only its tip is exposed. It is kept in the electrolyte solution in which the oxygen is allowed to
diffuse. The reference electrode is made up of silver-silver chloride (Ab/AgCl). A voltage of 0.7
is applied between the platinum wire and the reference electrode. The negative terminal is
connected to the active electrode through a micro ammeter and the positive terminal is given to
the reference electrode.
Figure 2.2 pO2 Electrode
Due to the negative terminal, the oxygen reduction takes place at the platinum cathode.
Finally the oxidation reduction current proportional to the partial pressure of oxygen diffused into
the electrolyte can be measured in the micro ammeter. The electrolyte is generally scaled in the
electrode chamber by means of a membrane through which the oxygen can diffuse from the
blood or sample solution.
There are two types of pO2 measurement. They are
I) Vitro measurement
II) Vivo measurement
SCE 35 DEPT.OF ECE
In case of dark electrode the platinum cathode and the reference electrode is present in a single
unit. This electrode is used for vitro and vivo measurements.
In Vitro Measurements
In this method the blood sample is taken and the measurement for oxygen saturation is
made in the laboratory. The electrode is placed in the sample blood solution and the pO2 value is
determined.
In Vivo Measurements
In this method the oxygen saturation is determined while the blood is flowing in the
circulatory system. A micro version of the pO2 electrode is placed at the tip of the catheter so that
it can be inserted into various parts of the heart or circulatory system.
The pO2 measurement also has some disadvantages in it. The reduction process in the
platinum cathode removes a finite amount of the oxygen from the cathode. And there is a gradual
reduction of current with respect to time. However careful design and proper procedures in
modern pO2 electrodes reduce the errors.
2.3 pCO2 MEASUREMENT
The term pco2 is defined as the partial pressure of carbon dioxide respectively. The
determination of pco2 is one the most important physiological chemical measurement. The
effective functioning of both respiratory and cardiovascular system can be by pco2 measurement.
The partial pressure of a gas is proportional to the quantity of that gas present in the blood.
The partial pressure of carbon dioxide can be measured with the help of pCO 2 electrodes.
Since there is a linear relationship between the logarithm of pCO2 and pH of a solution. The
pCO2 measurement is made by surrounding a pH electrode with a membrane selectively
permeable to CO2.
The modern improved pCO2 electrode is called as severinghous electrode. In this

electrode the membrane permeable to CO2 is made up of Teflon which is not permeable to other
ions which affects the pH value. The space between the Teflon and glass contains a matrix layer
which allows only the CO2 gas molecules to diffuse through it.
One of the demerits in older CO2 electrode is, it requires a length of time for the CO2
molecules to diffuse through the membrane. The modern CO2 electrode is designed in such a way
to overcome this demerit. Here the CO2 molecules diffuse rapidly through the membrane and the
measurement can be done easily.
2.4 MEASUREMENT OF PHCO3
• Blood gas analyzers are used to measure the content of pH, pCO and PO2 from the
blood.
• Two gases of accurately known O2 and CO2 percentages are required for
calibrating the analyzer in pO2 and pCO2 modes. These gases are used with
precision regulators for flow and pressure control.
SCE 36 DEPT.OF ECE

• Two standard buffers of known pH are required for calibration of the analyzer in
the pH mode.
• Input signal to the calculator is obtained from the outputs of the pH and pCO 2
amplifiers
• The outputs are adjusted by multiplying with a constant and are given to an adder
circuit
• The output of adder is passed to antilog generators circuit. Then it is passed to
A/D converter for display. Resistance R is used to adjust zero at the output.
• Total CO2 is calculated by summing the output signals of the calculators and the
output of the pCO2 amplifier
Figure 2.3 circuit diagram of computation of bicarbonate
The base excess calculator consists of three stages.
In the first stage, the output of pH amplifier is inverted in an operational amplifier, whose
gain is controlled by a potentiometer.
Figure 2.4 Circuit diagram for computation of base excess
SCE 37 DEPT.OF ECE

The output of HCO3—calculator is inverted in the second stage.

The third stage is a summing amplifier A3 whose output is given to A/D converter, that gives a
digital read out.
2.5 ELECTROPHORESIS
In clinical laboratories, various devices are used based on the electrophoretic principle.
These devices are used for the following applications.
 To measure the quantity of protein in plasma, urine, etc.

 To separate enzymes into their components is enzymes.
 To identify antibodies.
Basic principle
Electrophoresis is defined as the movement of a solid phase with respect to a liquid. The
buffer solution is used to carry the current and to maintain the pH value of the solution as a
constant one during the migration.
In this title, zone electrophoresis is explained. In this technique, the sample is applied to
the medium and under the effect of the electric field, group of particles that are similar in charge,
size, and shape migrate at the same rate. So the particles are separated into zones.
Factors Affect the Speed of Migration
Magnitude of charge:
The mobility of a given particle is directly related to the net magnitude of the particles
charge. Mobility is defined as, the distance in cm, a particle moves in unit time per unit field
strength.
Ionic Strength of Buffer
If the buffer is more concentrated then the migration of the particles is slow. Because, if
greater the proportion of buffer ions present, then greater the proportion of the current they carry.
Temperature:
Mobility is directly related to temperature. Heat is produced when the current flows
through the resistance of the medium. So, the temperature of the medium is increased and
resistance is decreased. Finally, the rate of migration is increased.
The water is evaporated from the surface of the medium due to heat. So, the concentration
of particle is increased. Finally the rate of migration is increased. When the gel is used as a
medium; this heat will create a problem. So, for this medium, constant current sources are used to
minimize the heat production.
Time: The distance of migration is related to the time period during which electrophoresis takes
place.
SCE 38 DEPT.OF ECE

Types of Support Media:
Cellulose acetate, starch gel and sucrose are used as support media in various
electrophoretic applications. We can see the cellulose acetate electrophoresis in the following
sections.
Cellulose Acetate Electrophoresis
Cellulose acetate strip is saturated with the buffer solution and placed in the membrane
holder. It is otherwise known as bridge. The two ends of the bridge are placed in the cuvette in
which buffer solution is available.
The sample for each test is placed on the strip at a marked location. Then, the constant
electric potential(250 V) is applied across the strip 4 – 6 mA of initial current is obtained .After
15-20mins, the electric voltage is removed, then, migrated protein band is stained with buffer
and it is dried in preparation for densitometry.
Figure 2.5 Pattern
The membrane is placed in the holder of densitometer. The path of the migration of
one of the specimen is scanned. The low voltage output is amplified and recorded using x-y
recorder.
Figure2.6 Cellulose acetate electrophoresis
SCE 39 DEPT.OF ECE

2.6 COLORIMETER
• Measures the color concentration of a substance in a solution by detecting the color light
intensity passing through a sample containing the substance and a reagent
• Optical color filters are used to detect the color wavelength of interest. E.g., urine passes
yellow light and absorbs blue and green
• Laser LEDs are preferred if their wavelength is suitable due to purity of the
monochromatic color.
Figure2.7 Colorimeter
Figure2.8 Concentration vs Absorbance
Transmittance
T= I1/I0 * 100%
Absorbance
A= - log I1/ I0
A=log 1/T
If the path length or concentration increases, the transmittance decreases and absorbance
increases, a phenomenon expressed by Beer’s Law.
Absorbtivity related to the nature of the A=aCL absorbing substance and optical
wavelength (known for a standard solutionconcentration).
C: Concentration
L: Cuvette path length
SCE 40 DEPT.OF ECE

2.7 PHOTOMETER
2.7.1 FLAME PHOTOMETER
Figure2.9 Flame Photometer
Measures the color intensity of a flame supported by O2 and a specific substance.

Sample’s emission of light is measured (rather than the absorbance of light).Typically used to
determine the conc. of pure metals and/or Na+, K+, Li+ and Ca++
In this method, fine droplets of the sample is aspirated into gas flame that burns in a
chimney. A known amount of lithium salt is added to the sample, as a reference. As a result, red
light is emitted by the lithium and yellow and violet beam are emitted due to sodium and
potassium respectively. These diffracted colours are made to incident on photodiodes. The photo
detector circuits consists of a reverse biased diode in which the current flow increases as intensity
of incident light increases. A calibration potentiometer is used in every channel. Since the lithium
is used as a standard reference, the output of sodium and potassium channel are calibrated in
terms of differences with the known lithium. The output can be compared with the spectral
illustration.
2.7.2 SPECTROPHOTOMETER
• The general name given to the group of instruments whose principle of operation is
based on the fact that substances of clinical interest selectively absorb or emit EM
energy (light) at different wavelengths.
SCE 41 DEPT.OF ECE

• Depending on the substance being measured, the wavelength used is typically in the
ultraviolet (200-400 nm), visible (400-700nm) or infrared (700 to 800 nm) range.
• Spectrophotometer can be used to determine the entity of an unknown substance, or the
concentration of a number of known substances.
• The type of source / filters used typically determines the type of the spectrophotometer.
• Rays of light bend around sharp corners, where the amount of bending depends on the
wavelength! This results in separation of light into a spectrum at each line.
• In spectrophotometer, selection filter of colorimeter is replaced by a monochromator.
Monochromatic uses a diffraction grating G to disperse light from the lamp. Light falls
through the slit S0 into its spectral components.
• Slit S1 is used for selecting a narrow band of the spectrum which is used to measure the
absorption of a sample in the cuvette.
• The light from the cuvette is given to photo detector. It converts light into a electrical
signal. This electrical signal is amplified by using an amplifier. The output from the
amplifier is given to meter which shows absorbance.
• Light absorption is varied when the wavelength is varied. Mirror M is used to reduce the
size of the instruments.
Figure 2.10 Spectrophotometer
SCE 42 DEPT.OF ECE

2.8 AUTOANALYZER
An auto analyzer sequentially measures blood chemistry through a series of steps of mixing,
reagent reaction and colorimetric measurements.
Itconsists of
• Sampler: Aspirates samples, standards, wash solutions into the system
• Proportioning pump: Mixes samples with the reagents so that proper chemical color
reactions can take place, which are then read by the colorimeter
• Dialyzer: separates interfacing substances from the sample by permitting selective
passage of sample components through a semi permeable membrane
• Heating bath: Controls temperature (typically at 37 °C), as temp is critical in color
development
• Colorimeter: monitors the changes in optical density of the fluid stream flowing through
a tubular flow cell. Color intensities proportional to the substance concentrations are
converted to equivalent electrical voltages.
• Recorder: Displays the output information in a graphical form.
Figure 2.11 Block diagram of Autoanalyzer
2.9 BLOOD FLOW METER
Blood flow meters are used to monitor the blood flow in various blood vessels and to
measure cardiac output.
Types
• Electromagnetic blood flow meters

• Ultrasonic blood flow meters
• Laser based blood flow meters
SCE 43 DEPT.OF ECE
2.15 BLOOD CELL COUNTER

• The blood cell counter count the number of RBC or WBC per unit of volume of blood
using either of two method:
– Electrical method called aperture impedance change
– Optical method called flow cytometry
Aperture impedance change

• When blood is diluted in the proper type of solution, the electrical resistivity of blood
cells (ρc) is higher then the resistivity of the surrounding fluid (ρf)
• By contriving a situation in which these resistivities can be differentiated from each other,
we can count cells
Blood cell sensing

• The sensor consist of a two-chamber vessel in which the dilute incoming blood is on one
side of barrier, and the waste blood to be discarded is on the other
• A hole with a small diameter (50μm) is placed in the partition between the tow halves of
the cell
• Ohmmeter measure the change on the resistance when the blood cell pass the aperture
Figure 2.36 Blood cell sensing
2.15.1 COULTER COUNTER

• Constant current source (CCS) and voltage amplifier replace the ohmmeter
• RA is the resistance of the aperture and will be either high or low, depending on whether
or not the blood cell is inside the aperture.
• Amplifier convert the current pulse to voltage pulse
SCE 68 DEPT.OF ECE

Figure 2.37 Block diagram of Coulter Counter
2.15.2 FLOW CYTOMETRY CELL COUNTERS
Optical flow cytometry sensing

• The optical cytometry sensor consists of a quartz sensing sheath designed with a
– hydrodynamic focusing region
– cell path region that passes only a single cell at time.
• Focusing is done by decreasing the diameter of the aperture.

• Light source is (He-Ne) Laser
• Two Photodetectors (photosensors)

– Photodetector A detects forward scatted light
– Photodetector B detects orthogonal scatted light
• blood sample enters the analyzer

– Optical counter → WBC count
– Colorimeter → hemoglobin
– Optical flow sensor → RBC count
SCE 69 DEPT.OF ECE

Figure 2.38 Optical flow cytometry
The blood is actually split into different chambers, where in each chamber it is diluted /
mixed to differentiate different cell types. WBC and RBC are separated (using lysing)
SCE 70 DEPT.OF ECE

Dr.V.Jayapradha BioMedicalElectronics

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SRI CHANDRASEKHARENDRA SARASWATHI VISWA MAHAVIDYALAYA

(University established under section 3of UGC Act 1956)

PEC5 BIO-MEDICAL ELECTRONICS VII SEMESTER

UNIT I BIO POTENTIAL ELECTRODES

DESIGN OF MEDICAL INSTRUMENT

3. Hysteresis: Hysteresis error occurs due to mechanical friction.

Fig 1.4: Block Diagram of a Generalized Bio-Medical Instrument System

2.1: Sources of Biomedical Signals

Fig. 1.8 Sources of biomedical signals

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 2

Bioacoustic Signals: The measurement of acoustic signals created by many biomedical

Bio-impedance Signals: The impedance of the tissue is a source of important information

2.2: Origin of Bioelectric Signals

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 3

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 4

Fig. 2.1 A typical cell potential waveform

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 5

Fig. 2.2 Electrical activity associated with one contraction in a muscle

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 6

2.3 : Electrocardiogram (ECG)

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 7

2.8: Recording Electrodes–Electrode-tissue interface,

2.8.1 ELECTRODE TISSUE INTERFACE

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 14

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 15

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 16

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 17

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 18

SKIN CONTACT IMPEDANCE :

Measurement of Skin Contact Impedance: A convenient method to measure the contact

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 19

• Plastic cup self-adhesive electrodes (Boter et al, 1966)

• Metal plate limb electrodes used with conducting jelly

• Metal plate electrodes used with conducting plastic (Jenkner, 1967)

• Dry multi-point limb electrodes (Lewes, 1966)

• Dry multi-point suction chest electrodes

• Self-adhesive multi-point chest electrodes used with conducting jelly

• Self-adhesive gauze electrodes

• Self-adhesive dry multi-point chest electrodes (Lewes and Hill, 1967)

Motion artefact is a problem in biopotential measurements. The problem is greatest in cardiac

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 20

2.9 Silver-Silver Chloride electrodes

Production of Silver-Silver Chloride Electrodes: Silver-silver chloride electrodes are

Hemanth kumar G , Asst Prof, Dept. of BME, ACSCE Page 21

Electromyogram [EMG]: EMG is the record of electrical activity of muscles.

Typical bandwidth: 300-3000 Hz

Employed to pick up the electrical signals of the body

Pair of electrodes play the role of a transducer

Amplifier has to be designed – to accommodate the characteristics of electrodes

Electrical characteristics of the electrodes specify the type of preamplifier

For microelectrodes, many restrictions on the input impedance of the amplifier

MEDICAL ELECTRONICS LECTURE NOTES © Ms.V.Ezhilya,AP/ECE

The microelectrodes are very small in diameter and so it will not

Microelectrodes are classified into Metallic & Non-Metallic.

The metal microelectrodes are formed by electrolytically etching the tip

Final potential = EA-ER

MEDICAL ELECTRONICS LECTURE NOTES © Ms.V.Ezhilya,AP/ECE

Depth electrodes are used to measure the oxygen tension.

In some depth electrode, the supporting element is in the form of capillary

1. Monopolar needle electrode.

2. Bipolar needle electrode.

MEDICAL ELECTRONICS LECTURE NOTES © Ms.V.Ezhilya,AP/ECE

The smaller area surface electrodes are used to measure EEG,EMG